{"title":"Neurogenic Laryngeal Disorders","authors":"Y. Yiu, Teresa Procter","doi":"10.2310/ot.7068","DOIUrl":"https://doi.org/10.2310/ot.7068","url":null,"abstract":"The larynx is critical to performing complex tasks of airway protection, phonation, respiration, and deglutition. Various focal and systemic neurologic disorders impact the larynx, causing deficits that lead to dysfunction in voice, speech, breathing, and swallowing function. The most common hyperfunctional neurolaryngeal disorders include spasmodic dysphonia (laryngeal dystonia), essential vocal tremor, and muscle tension dysphonia. Some hypofunctional neurolaryngeal disorders include parkinsonian disorders, neuromuscular junction diseases, and myopathies. A multidisciplinary approach involving evaluation by neurologists, voice-trained otolaryngologists and speech-language pathologists is often key to diagnosis and treatment of these challenging and sometimes lifelong disorders. Botulinum toxin injection into the laryngeal musculature is currently the gold-standard treatment for both spasmodic dysphonia and vocal tremor. However, much research is being conducted to advance less invasive and more definitive medical and surgical treatment interventions.\u0000\u0000This review contains 3 figures, 11 videos, 6 tables and 29 references\u0000Keywords: laryngeal neurophysiology, laryngeal dystonia, adductor spasmodic dysphonia, abductor spasmodic dysphonia, essential vocal tremor, hyperfunctional voice disorders, hypofunctional voice disorders, botulinum toxin injection","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121864987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mandible Fractures","authors":"John J. Chi, Emily Konkus","doi":"10.2310/ot.7103","DOIUrl":"https://doi.org/10.2310/ot.7103","url":null,"abstract":"Mandible fractures are often caused by blunt or penetrating trauma and are one of the most common facial fractures. It is critical to understand facial and mandibular anatomy to best evaluate, classify, and treat mandible fractures. The primary goal of treatment is to restore the jaw to the preinjury occlusion. This can be achieved through open reduction with internal fixation or closed reduction with maxillomandibular fixation (MMF) in conjunction with dietary changes and/or physiotherapy. The main risks and concerns in mandible fracture management are infection, malunion, airway compromise, pain, and temporomandibular joint (TMJ) dysfunction. This chapter will provide a brief overview of facial and mandibular anatomy as well as common treatment methods and surgical interventions. \u0000\u0000This review contains 17 figures, 2 tables, and 43 references\u0000Key words: Mandibular fracture, maxillomandibular fixation, occlusion, malunion, closed reduction, open reduction, TMJ dysfunction","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122044041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shared Decision Making","authors":"Apurupa Ballamudi, John Chi","doi":"10.2310/ot.7108","DOIUrl":"https://doi.org/10.2310/ot.7108","url":null,"abstract":"Shared decision-making (SDM) is a process in which patients and providers work together to make medical decisions with a patient-centric focus, considering available evidence, treatment options, the patient’s values and goals, and risks and benefits. It is important for all providers to understand how to effectively use SDM in their interactions with patients to improve patients’ experiences throughout their healthcare journey. There are strategies to improve communication between patients and their providers, particularly when communicating quantitative data, risks and benefits, and treatment options. Decision aids (DAs) can help patients understand complex medical information and make an informed decision.\u0000\u0000This review contains 9 figures, 4 tables and 45 references\u0000Key words: Shared decision-making, decision-making, communication, risk and benefit, patient-centered, health literacy, quality of life, decision aids, option grid, pictographs.","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126805921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Local Flaps and Grafts","authors":"Adam McCann, T. Hsieh","doi":"10.2310/ot.7089","DOIUrl":"https://doi.org/10.2310/ot.7089","url":null,"abstract":"Reconstruction of facial defects is a complex process that when done well can have a significant positive impact on patients’ quality of life. While the variety of specific facial defects and their causes seems endless, it is important to understand that several core tenets in local reconstruction such as facial anatomy and aesthetics, appropriate patient selection, as well as surgical technique can aid in successful repair in most cases.\u0000\u0000This review contains 17 figures, 1 table and 28 references\u0000Key words: Local flap; skin grafts; facial reconstruction; skin cancer","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128071641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic Rhinosinusitis","authors":"B. Tajudeen","doi":"10.2310/ot.7049","DOIUrl":"https://doi.org/10.2310/ot.7049","url":null,"abstract":"Chronic sinusitis (CRS) is a long-standing mucosal inflammatory disease of the sinonasal tract that results in significant impairment in patient quality of life. The pathogenic determinants of disease include chronic mucosal inflammation, local microbial colonization, and mucociliary dysfunction. A thorough understanding of this tripartite model allows for endotyping and tailored therapy. Medical therapy in the form of oral and/or topical therapy is imperative to reduce mucosal inflammation, treat microbial infection, and enhance mucociliary function. Functional endoscopic sinus surgery (FESS) serves to surgically reduce inflammatory load, ventilate the sinuses, augment installation of topical therapy, and provide tissue for endotyping. The end result of well-performed surgery is a unified sinus cavity augmented for improved medical therapy. Newer therapeutics, such as biologic therapies, target TH-2 driven mucosal inflammation and are gaining an emerging role in the management of CRS; however, the role of these therapies is not well defined in the current treatment paradigm.\u0000\u0000This review contains figures, tables and references\u0000Key words: chronic sinusitis, chronic rhinosinusitis, functional endoscopic sinus surgery, topical steroid therapy, endotype, structured histopathology, nasal polyps, biologic therapy, mucociliary dysfunction, biofilms","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117061111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Approach to Difficult Airway Management","authors":"L. Matrka, L. Soldatova","doi":"10.2310/ot.7058","DOIUrl":"https://doi.org/10.2310/ot.7058","url":null,"abstract":"According to the 2013 American Society of Anesthesiology Practice Guidelines for Management of the Difficult Airway, a term “difficult airway” refers to clinical situations in which a likelihood of 1) difficulty with patient cooperation or consent, 2) difficult mask ventilation, 3) difficult supraglottic airway placement, 4) difficult laryngoscopy, 5) difficult intubation, and/or 6) difficult surgical airway is high. Several considerations are important when approaching each individual clinical scenario. An airway management plan should include patient-specific and situation-specific factors that take into account findings of bedside airway evaluation, prior history of intubations, the acuity of the situation requiring intubation, and the level of airway obstruction. The following module provides an overview of these factors along with a brief introduction to specific clinical situations in which some airway management strategies are more suitable.1,2\u0000This review contains 10 figures, 7 tables and 32 references\u0000Key words: Difficult airway, intubation, LEMON score, High-Flow Nasal Cannula Oxygenation, THRIVE","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122364548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disorders of Taste and Smell","authors":"Jackson Vuncannon, J. Levy","doi":"10.2310/OT.7052","DOIUrl":"https://doi.org/10.2310/OT.7052","url":null,"abstract":"Among sensory abilities, smell and taste are the mechanisms through which humans sample chemicals in the environment, also known as chemoreception. These chemosensory abilities allow us to appreciate pleasurable environmental stimuli and provide critical information for the avoidance of potentially toxic compounds or environmental dangers. Correspondingly, dysfunction of these sensory abilities has repercussions not only for quality of life, but also personal safety. In this module, we will undertake an in-depth discussion of chemosensory dysfunction beginning with definitions of olfactory dysfunction and taste disturbance and associated epidemiology. Normal physiology and pathophysiology of chemosensory disorders are reviewed, along with associations of chemosensory disorders to other diseases of the head and neck. An overview of appropriate components of patient history and physical examination follows, with a discussion of indications for further testing. Finally, treatment modalities and patient outcomes for olfactory dysfunction and taste disturbance are highlighted.\u0000This review contains 3 figures, 8 tables and 76 references.\u0000Key Words: Olfactory Dysfunction, Gustatory Dysfunction, Chemosensation, Evaluation of smell loss, Evaluation of taste loss, Olfactory Training","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130313481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Deep Space Neck Infections","authors":"T. Hassanzadeh, J. Tracy","doi":"10.2310/OT.7006","DOIUrl":"https://doi.org/10.2310/OT.7006","url":null,"abstract":"Deep neck space infections are a common reason for otolaryngology consultation. The anatomic spaces and their relationships are complex, and inappropriately treated infections may pose life-threatening consequences. It is critical for the practicing otolaryngologist to understand the boundaries and contents of the fascial spaces, microbiology of involved organisms, clinical workup, indications for medical and surgical management, and potential complications.\u0000This review contains 15 figures, 3 tables and 25 references. \u0000Key Words: Nodes of Rouviere, Danger space, Ludwig’s angina, Lemierre syndrome, Cavernous sinus thrombosis, Necrotizing fasciitis, Bezold abscess","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125432569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epistaxis","authors":"Tran B. Locke, Philip G. Chen","doi":"10.2310/ot.7053","DOIUrl":"https://doi.org/10.2310/ot.7053","url":null,"abstract":"Epistaxis, also known as nosebleeds, is a commonly treated condition in medicine and especially otolaryngology. 1 in 200 emergency room visits are due to acute epistaxis, with a higher frequency during the winter and among young children and the elderly. A strong understanding of the etiology, anatomy, and available therapeutic options is necessary for optimal management of epistaxis.1,2\u0000This review contains 11 figures, 5 tables, 1 video, and 66 references.\u0000Keywords: epistaxis, nose bleed, nasal packing, hemostasis, nasal cauterization, arterial ligation, arterial embolization, hereditary hemorrhagic telangiectasias","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128365502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tracheal Disorders","authors":"K. O'Dell, Neel K. Bhatt","doi":"10.2310/ot.7063","DOIUrl":"https://doi.org/10.2310/ot.7063","url":null,"abstract":"Laryngotracheal stenosis (LTS) can occur secondary to narrowing or collapse of the upper airway. This chapter highlights the etiologies, workup, and management for LTS, specifically looking at subglottic, tracheal, and laryngeal stenosis. There are several etiologies for stenosis including trauma, intubation, tracheotomy tube placement, and autoimmune disease. Careful attention to the underlying causes of LTS guides the appropriate workup and treatment. Advances in in-office endoscopy and procedures have improved the ability to visualize thestenosis, biopsy tissue, and treat the stenosis in the awake patient. For tracheal and subglottic narrowing, open resection and anastomosis is sometimes necessary, and this chapter addresses important technical and post-operative considerations. Finally, this chapter addresses the challenges associated with laryngeal stenosis, with particular attention to the workup and surgical treatments for posterior glottic stenosis (PGS).\u0000This review contains 12 figures, 3 videos, 3 tables, and 36 references. \u0000Key Words: laryngeal stenosis, subglottic stenosis, tracheal stenosis, dyspnea, laryngotracheal stenosis, posterior glottic stenosis","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124423970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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