Current Opinion in Otolaryngology & Head and Neck Surgery最新文献

Rhinology in the developing world - an important yet frequently overlooked theme.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-03 DOI: 10.1097/MOO.0000000000001047

Emma Stapleton

引用次数: 0

Granulomatous disorders of the nose and paranasal sinuses: perspective from low- and middle-income countries.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-03 DOI: 10.1097/MOO.0000000000001048

Baskaran Ranganathan, Kiran Natarajan, Raghu Nandhan, Amr Abdlehamid

{"title":"Granulomatous disorders of the nose and paranasal sinuses: perspective from low- and middle-income countries.","authors":"Baskaran Ranganathan, Kiran Natarajan, Raghu Nandhan, Amr Abdlehamid","doi":"10.1097/MOO.0000000000001048","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001048","url":null,"abstract":"Purpose of review: This is a comprehensive overview of current trends in the prevalence, clinical presentation, diagnostic challenges and management of granulomatous disorders involving the nose and paranasal sinuses in low- and middle-income countries. Emphasis is placed on infective aetiologies contributing to granulomatous diseases and the emerging innovations in the diagnosis and management of these conditions.Recent findings: Granulomatous inflammations represent a distinctive spectrum of conditions arising from infectious, autoimmune, neoplastic, and chemical exposures. The prevalence of these disorders varies globally, with infectious aetiologies being more common in subtropical regions and autoimmune inflammatory conditions predominating in Western countries. Notably, the global burden of certain infectious granulomatous diseases is declining due to improved awareness, socio-economic conditions, and enhanced access to healthcare.However, the incidence of invasive fungal mucormycosis has risen sharply following the COVID-19 pandemic, particularly in the Indian subcontinent. Contributing factors include diabetes mellitus, excessive use of high-dose corticosteroids, and environmental influences. Early diagnosis, along with aggressive surgical debridement and antifungal therapy, remains critical for successful management.Summary: Otolaryngologists must be aware of granulomatous conditions affecting the nose and paranasal sinuses, given their potential to cause significant morbidity if left untreated. Timely diagnosis relies on clinical suspicion supported by blood tests, imaging, and histopathology for effective intervention.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epistaxis management in Nigeria: strength, challenges and recommendations.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-03 DOI: 10.1097/MOO.0000000000001049

Oyeleye A Oyelakin, Samuel O Ayodele, Ayotunde J Fasunla

{"title":"Epistaxis management in Nigeria: strength, challenges and recommendations.","authors":"Oyeleye A Oyelakin, Samuel O Ayodele, Ayotunde J Fasunla","doi":"10.1097/MOO.0000000000001049","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001049","url":null,"abstract":"Purpose of review: The purpose of this study was to review epistaxis management in Nigeria in the context of current global rhinology practice. It aimed to identify the current strengths in practice that require consolidation and the gaps that require recommendations.Recent findings: The consistent predominance of otolaryngological interventions in tertiary hospitals reflects the paucity of specialists and lack of equipment for the optimal management of epistaxis in primary and secondary healthcare facilities in Nigeria. Endoscopic intervention was apparent in the most recent publications, but it is still a key limitation, given that it is not widely available in all facilities. The commencement of rhinology fellowships and the emergence of interventional radiology is a ray of hope for an imminent, excellent practice.Summary: Management of nosebleeds in Nigeria is safe despite limited resources. We believe that there has been progress in endoscopic management; however, this is not widely available. Therefore, there is a need for inclusive advancement. Moreover, local management guidelines would be an excellent tool for unified practice in the advent of rhinology fellowships and evolving interventional radiology. It is vital to fortify primary and secondary health systems.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Techniques for maxillomandibular fixation: old and new.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-02 DOI: 10.1097/MOO.0000000000001043

Sarah Rathnam Akkina, Scott Eric Bevans, Alan Wellington Johnson

{"title":"Techniques for maxillomandibular fixation: old and new.","authors":"Sarah Rathnam Akkina, Scott Eric Bevans, Alan Wellington Johnson","doi":"10.1097/MOO.0000000000001043","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001043","url":null,"abstract":"Purpose of review: Maxillomandibular fixation (MMF) is essential for many surgeries on the bony middle and lower face. MMF techniques have multiplied in recent years, each with unique benefits and drawbacks. This review catalogs MMF trends and evidence for and against the most prevalent MMF methods.Recent findings: Traditional Erich arch bars remain the most robust technique in establishing MMF, particularly for comminuted/complicated fractures. Drawbacks are increased operative time required, wire stick injuries, poor oral hygiene, and gingival trauma. Screw-based techniques save considerable time but cannot stabilize comminuted fractures as adequately and risk tooth root and nerve damage. Embrasure wires offer time and cost savings but are solely for intraoperative use and uncomplicated fractures. Similarly, dental occlusion ties provide the benefits of reduced time and wire sticks, with the added capability of postoperative use, but require adequate dentition and minimally displaced fractures. Recent studies show decreased use of wire-based techniques, with increased adoption of hybrid systems and dental occlusion ties.Summary: MMF techniques each have unique advantages and weaknesses. Selection should depend on surgical goals, including the severity of fractures, the need to maintain occlusion postoperatively, application/removal time, safety, and patient comfort.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1097/MOO.0000000000001034

引用次数: 0

Practical considerations for choosing transoral laser microsurgery versus transoral robotic surgery for supraglottic laryngeal cancers.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-01-29 DOI: 10.1097/MOO.0000000000001028

Jerome R Lechien, Carlos M Chiesa-Estomba, Stéphane Hans

{"title":"Practical considerations for choosing transoral laser microsurgery versus transoral robotic surgery for supraglottic laryngeal cancers.","authors":"Jerome R Lechien, Carlos M Chiesa-Estomba, Stéphane Hans","doi":"10.1097/MOO.0000000000001028","DOIUrl":"10.1097/MOO.0000000000001028","url":null,"abstract":"Purpose of review: To review the pros and cons of treating supraglottic laryngeal cancer with transoral laser microsurgery (TOLM) or transoral robotic surgery (TORS).Recent findings: The use of TORS is limited by the cost and the availability of the robots despite a faster learning curve than TOLM. The laryngeal exposure difficulty, the use of long instruments, and the restricted view of the surgical field consist of the primary limitations of TOLM, which are addressed in TORS technology through a 30° view of surgical fields, and the 180° amplitude of the instruments. The indications of TOLM and TORS are similar and include cT1-T2 and some selected cT3 with moderate invasion of the preepiglottic space. The rates of positive margins in TORS-SGL are lower than those of TOLM-supraglottic laryngectomy (SGL), while both approaches report similar duration of hospital stays. Patients treated with TORS report higher rates of percutaneous gastrostomy and temporary tracheotomy compared to TOLM. The feeding tube and oral diet re-start appear comparable between both groups. The overall survival, disease-free survival, local, regional, and relapse-free survival rates of TORS are reported to be higher than those found for TOLM SGL.Summary: TORS and TOLM SGL are well tolerated and effective approaches for cT1, cT2, and some selected cT3 LSCC. The functional and surgical outcomes appear comparable. TORS could have superior survival and loco-regional outcomes than TOLM, which could be attributed to the fastest TORS learning curve, and its superiority in terms of tumor/operating field visualization, and instrument movements.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"92-101"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral carotid body tumor management: tips, tricks, strategies, and problems.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-01-29 DOI: 10.1097/MOO.0000000000001035

Cesare Piazza, Claudia Montenegro, Vittorio Rampinelli

{"title":"Bilateral carotid body tumor management: tips, tricks, strategies, and problems.","authors":"Cesare Piazza, Claudia Montenegro, Vittorio Rampinelli","doi":"10.1097/MOO.0000000000001035","DOIUrl":"10.1097/MOO.0000000000001035","url":null,"abstract":"Purpose of review: Carotid body tumors (CBTs) are rare neuroendocrine tumors with an annual incidence of 1 : 30 000. Bilateral carotid body tumors (BCBTs) account for 3-5% of all CBTs and are more frequently linked to familial syndromes and potential malignancy. BCBT management is still not universally standardized and depends on multiple factors, including patient's age, risk of malignancy, location, growth rate, size, and related Shamblin and Mehanna classifications.Recent findings: Options of treatment include active surveillance, external beam radiation, and surgery. Surgery is the first-choice treatment, but it may not always be performed especially in elderly patients. Simultaneous BCBT resection is not suggested due to high intra-operative and postoperative risks. The decision to operate on the larger or smaller tumor first is still debated. Whenever feasible, treatment of the larger tumor first to reduce the tumor burden should be preferred but with higher risks of neurovascular injury. Conversely, starting with the smaller tumor first offers a lower risk at initial surgery but may complicate the management of the larger tumor later.Summary: Surgery for BCBTs, whenever feasible, remains the most indicated treatment but poses a significant risk of neurovascular complications. Resection of the larger, often more symptomatic, and potentially problematic or malignant tumor, reduces the overall disease burden and mitigates risks of rapid progression but involves a higher immediate complication hazard. Multidisciplinary evaluation is essential for balancing surgical risks and long-term outcomes, prioritizing neurovascular preservation and reducing morbidity.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"123-130"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modern management of distant metastases from head and neck squamous cell carcinoma. 头颈部鳞状细胞癌远处转移的现代治疗方法。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-11-13 DOI: 10.1097/MOO.0000000000001024

Patrick Bradley, Claudia Montenegro, Cesare Piazza

{"title":"Modern management of distant metastases from head and neck squamous cell carcinoma.","authors":"Patrick Bradley, Claudia Montenegro, Cesare Piazza","doi":"10.1097/MOO.0000000000001024","DOIUrl":"10.1097/MOO.0000000000001024","url":null,"abstract":"Purpose of review: The rate of distant metastases in patients with head and neck squamous cell carcinoma (HNSCC) ranges between 4 and 26%. Their appearance marks a critical stage in disease progression, significantly reducing survival rates. Treatment options require a multidisciplinary approach and differ based on the number and extension of distant metastases. The aim of this narrative review is to provide a comprehensive and updated overview of the current state of the art in management of such a clinical scenario.Recent findings: Accurate detection and staging of distant metastases are essential to determine prognosis and guide therapeutic strategies. Oligometastatic condition refers to patients with only a few distant metastases (up to 5). Surgery or stereotactic body radiotherapy are the best curative treatment options for oligometastatic. However, the majority of HNSCC has a polymetastatic disease, not amenable to curative approach. Therefore, systemic therapies, including chemotherapy (CHT) or target molecular therapy and/or best supportive care, are usually reserved to these patients. Rarely, head and neck region, in particular supraclavicular cervical lymph nodes, may be a site of distant metastases from non-head and neck cancer, particularly from the genitourinary and gastrointestinal tracts.Summary: The occurrence of distant metastases in HNSCC represents a pivotal point in the disease progression, lowering survival rates. Pattern of distant metastases has been related to survival outcomes. Patients with distant metastases from an HNSCC always require a multidisciplinary approach and an accurate selection is necessary to individualize the best treatment strategy.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"115-122"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parapharyngeal space metastasis from squamous cell carcinoma: indications and limits of different surgical approaches. 鳞状细胞癌咽旁间隙转移：不同手术入路的适应症和局限性。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1097/MOO.0000000000001029

Matteo Fermi, Carlotta Liberale, Gabriele Molteni

{"title":"Parapharyngeal space metastasis from squamous cell carcinoma: indications and limits of different surgical approaches.","authors":"Matteo Fermi, Carlotta Liberale, Gabriele Molteni","doi":"10.1097/MOO.0000000000001029","DOIUrl":"10.1097/MOO.0000000000001029","url":null,"abstract":"Purpose of review: The aim of this review is to investigate the most suitable surgical approach to managing parapharyngeal space (PPS) squamous cell carcinoma (SCC) metastasis.Recent findings: SCC metastasis in PPS are extremely rare. The PPS itself is a complex anatomical area, requiring extensive surgical experience and various surgical approaches for effective management. Several authors have attempted to systematize the surgical approaches to the PPS based on the anatomical location and histological nature of the lesions. However, there are currently few studies in the literature on the specific management of SCC metastases in the PPS, as these lesions are extremely rare.Summary: The treatment of SCC metastases in the PPS must be determined based on the individual patient. If the patient is a candidate for surgery, the surgical approach should be chosen based on the location of the metastases and must ensure a sufficiently wide surgical corridor to allow for as complete a resection as possible. To date, the surgical approach that best meets these requirements is the transcervical transparotid approach. With new technologies, including the use of robotics and endoscopy, surgery can become increasingly less invasive while maintaining the wide exposure provided by open surgical procedures.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"74-78"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skull base osteoradionecrosis: from pathogenesis to treatment.

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-04-01 Epub Date: 2025-01-31 DOI: 10.1097/MOO.0000000000001036

Vittorio Rampinelli, Gabriele Testa, Alberto Daniele Arosio, Cesare Piazza

{"title":"Skull base osteoradionecrosis: from pathogenesis to treatment.","authors":"Vittorio Rampinelli, Gabriele Testa, Alberto Daniele Arosio, Cesare Piazza","doi":"10.1097/MOO.0000000000001036","DOIUrl":"10.1097/MOO.0000000000001036","url":null,"abstract":"Purpose of review: This review aims to provide a comprehensive analysis of skull base osteoradionecrosis (ORN), a severe and rare complication of radiotherapy for head and neck malignancies. It explores pathogenesis, clinical presentation, diagnostic strategies, and management approaches, emphasizing the importance of multidisciplinary care in addressing this challenging condition.Recent findings: Skull base ORN results from radiotherapy-induced tissue damage, characterized by hypovascularity, hypoxia, and necrosis, often compounded by secondary infections. Advances in radiotherapy techniques, such as intensity-modulated radiotherapy and heavy particles, have reduced ORN incidence, though cases persist, particularly in high-dose radiotherapy fields. Emerging treatments, including hyperbaric oxygen therapy and the pentoxifylline-tocopherol protocol, show promise but lack robust evidence for standardized use. Surgical interventions, especially those incorporating vascularized tissue reconstruction, have demonstrated favorable outcomes in refractory cases. Recent studies underscore the utility of multimodal imaging techniques, including MRI and PET/CT, for distinguishing ORN from tumor recurrence.Summary: Skull base ORN represents a complex and potentially life-threatening condition requiring tailored, multidisciplinary management. Although advancements in diagnostics and therapeutics have improved outcomes, significant challenges remain, particularly in developing standardized protocols. Further research is needed to refine treatment strategies and improve evidence-based practices for this entity.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"65-73"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0