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

{"title":"Modern methods of dorsal augmentation rhinoplasty.","authors":"Beatrice C Go, Roy Xiao, Yong Ju Jang","doi":"10.1097/MOO.0000000000001139","DOIUrl":"10.1097/MOO.0000000000001139","url":null,"abstract":"<p><strong>Purpose of review: </strong>Dorsal augmentation rhinoplasty is a technically demanding procedure that requires careful selection of grafting materials and techniques to achieve durable and aesthetically pleasing results. This review summarizes contemporary approaches to dorsal augmentation rhinoplasty, emphasizing material selection, surgical indications, and evolving techniques.</p><p><strong>Recent findings: </strong>Autologous grafts (septal, auricular, and costal cartilage) are widely used due to their lack of immunogenicity and relatively low rates of infection and extrusion. Diced cartilage techniques have gained recent popularity due to their flexibility and smooth dorsal contouring. Alloplastic and allogeneic materials can be carefully considered in specific patient populations who accept their associated risks. Injection filler rhinoplasty may be considered for patients seeking a lower-cost, temporary option for nasal augmentation with minimal downtime.</p><p><strong>Summary: </strong>A comprehensive understanding of the spectrum of surgical techniques for dorsal augmentation rhinoplasty is essential for individualized surgical planning. Familiarity with the indications, strengths, and limitations of each approach will enable surgeons to optimize outcomes in dorsal augmentation rhinoplasty.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"225-233"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213598","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}

{"title":"Update in facial reanimation: neurorrhaphy, interposition grafting, nerve transfers and bioengineered options.","authors":"Isabelle L Magro, Travis T Tollefson, Alexander P Marston","doi":"10.1097/MOO.0000000000001131","DOIUrl":"10.1097/MOO.0000000000001131","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to summarize recent advances in facial nerve repair and facial reanimation as it relates to neurorrhaphy techniques, bioengineered options and nerve transfers.</p><p><strong>Recent findings: </strong>Direct neurorrhaphy is the gold standard for facial nerve repair when tension-free repair is achievable. Interposition grafting with autologous donor nerves facilitates repair when a tension-free repair is not feasible. Adjunctive bioengineered materials have been developed to enhance nerve repair, but high-quality clinical evidence supporting their use in facial nerve reconstruction remains limited. Nerve transfers can be employed when direct repair or interposition grafting is not possible, such as when the proximal nerve stump is absent, or when recovery after primary or interposition repair is unlikely.</p><p><strong>Summary: </strong>Significant advances have been made in facial nerve reconstruction. Multiple bioengineered materials are now available with the potential for improved outcomes; however, few have shown significant efficacy in clinical studies. High-quality clinical research and prospective investigation are needed to justify and predict when to best use these materials.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"249-257"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846707","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}

{"title":"The adult cleft lip and palate patient: beyond primary repair.","authors":"Geethanjeli Mahendran, Robin Reinke Cullinane, David A Shaye","doi":"10.1097/MOO.0000000000001133","DOIUrl":"10.1097/MOO.0000000000001133","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cleft lip and palate (CL/P) is the most common congenital craniofacial anomaly worldwide. While surgical techniques and multidisciplinary cleft care have advanced substantially, much of the literature focuses on pediatric outcomes. The long-term experiences of adults living with CL/P remain comparatively underexplored. This article aims to review the functional, psychological, and social experiences of adults with CL/P and consider how these factors influence long-term care.</p><p><strong>Recent findings: </strong>Adults with CL/P face persistent functional challenges including speech difficulties, hearing loss related to chronic eustachian tube dysfunction (ETD), nasal airway obstruction, and dentofacial abnormalities that may require orthognathic correction. Psychological studies reveal higher rates of depression, anxiety, and social stigma among adults with CL/P, with protective factors including family support and engagement with the cleft community. Patient-reported outcome measures suggest that satisfaction with surgical outcomes varies by cleft phenotype, with bilateral clefts often associated with lower satisfaction and a higher likelihood of revision procedures such as secondary rhinoplasty.</p><p><strong>Summary: </strong>Adults with CL/P face challenges of ongoing functional adaptation, psychosocial navigation, and decisions regarding additional interventions. Attention to patient-reported outcomes, psychosocial support, and lifelong engagement with cleft care may improve the long-term well being of adults living with CL/P.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"265-270"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846719","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}

{"title":"Advances in forehead flap nasal reconstruction: from design to division.","authors":"Catherine F Roy, David A Shaye","doi":"10.1097/MOO.0000000000001134","DOIUrl":"10.1097/MOO.0000000000001134","url":null,"abstract":"<p><strong>Purpose of review: </strong>The forehead flap is a cornerstone of reconstruction for large and complex nasal defects. Despite its ancient origins, flap design, staging, and perioperative management continue to evolve. This review summarizes contemporary advances and evidence-based considerations that inform modern use of the forehead flap.</p><p><strong>Recent findings: </strong>Improved anatomical understanding of the supratrochlear and dorsal nasal arterial systems has enabled alternative pedicle designs, which may reduce hair transposition and eyebrow distortion while maintaining reliable perfusion. Donor site management strategies favor primary closure and secondary intention healing over skin grafting to optimize cosmesis. While the traditional two-stage approach remains standard, selected patients may benefit from single-stage reconstruction or three-stage techniques. Objective tools such as indocyanine green angiography and Doppler ultrasonography have been explored to guide earlier pedicle division in select patients. Overall complication rates remain low, with smoking, full-thickness defects and cartilage grafting associated with increased risks of bleeding and infection.</p><p><strong>Summary: </strong>The forehead flap remains a highly reliable and versatile reconstructive option for nasal defects. Contemporary modifications in flap design, staging and donor site management allow surgeons to optimize both functional and aesthetic outcomes.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"271-278"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965577","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}

{"title":"Cleft related facial skeletal surgery: an update.","authors":"Karandeep Singh Randhawa, Alexander Graf, Sherard Tatum","doi":"10.1097/MOO.0000000000001127","DOIUrl":"10.1097/MOO.0000000000001127","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides a comprehensive update on advancements and evolving paradigms in cleft-related facial skeletal surgery. It evaluates recent literature concerning the integration of artificial intelligence in surgical prediction, optimal orthognathic surgical sequencing, the utility of virtual surgical planning (VSP) and patient-specific implants (PSIs), strategies for managing skeletal surgery related velopharyngeal insufficiency (VPI) and airway patency, the evolution of alveolar bone grafting (ABG) techniques, and the increasing emphasis on patient-reported outcome measures (PROMs).</p><p><strong>Recent findings: </strong>Recent studies demonstrate that machine learning models utilizing preadolescent cephalometric data can predict the need for orthognathic surgery with high accuracy (over 83%). The implementation of 3D VSP has validated the mandible-first surgical sequence and significantly improved occlusal accuracy while reducing preoperative planning time. While PSIs reduce skeletal relapse in large maxillary advancements (>10 mm), they carry a higher risk of hardware removal compared to conventional plates. Regarding speech and airway management, safe maxillary advancement thresholds have been established to minimize VPI risk, and preserving prior pharyngeal flaps during surgery, if possible, is highly recommended to prevent speech deterioration. In alveolar reconstruction, synthetic grafts and allografts combined with osteogenic agents (like rhBMP-2) are showing success rates comparable to traditional iliac cancellous autografts, with a marked shift toward earlier intervention (ages 4-8) and outpatient procedures. Finally, while orthognathic surgery significantly improves psychosocial well being and facial aesthetics, significant disparities in care access persist based on insurance status and geopolitical factors.</p><p><strong>Summary: </strong>The landscape of cleft-related facial skeletal surgery is rapidly advancing through the integration of artificial intelligence, 3D digital planning, and novel biomaterials. These innovations allow for earlier, more accurate surgical predictions, reduced operative morbidity, and enhanced long-term skeletal stability. Balancing structural advancements with airway and speech preservation remains a delicate, patient-specific process. Ultimately, while surgical and technological refinements continue to optimize functional and aesthetic results, addressing socioeconomic barriers is critical to ensuring timely care and maximizing health-related quality of life for all cleft patients.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"279-285"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629247","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}

{"title":"Surgical techniques for caudal septal deviations.","authors":"Joseph Latif, Emma Ho, Catherine Meller","doi":"10.1097/MOO.0000000000001130","DOIUrl":"10.1097/MOO.0000000000001130","url":null,"abstract":"<p><strong>Purpose of review: </strong>Caudal septal deviation represents a challenging surgical problem with significant functional and aesthetic implications. This review examines recent advances in surgical techniques for correcting caudal septal deviations, with emphasis on appropriate technique selection based on deviation type and severity.</p><p><strong>Recent findings: </strong>The surgical management of caudal septal deviation has evolved toward more nuanced, tissue-preserving approaches that balance adequate correction with maintenance of structural integrity. Contemporary practice emphasizes cartilage remodelling when anatomically appropriate, with techniques ranging from simple suture stabilization to complex reconstruction with grafting. Improved understanding of nasal septal biomechanics, including regional thickness variations and critical junction points, has enabled more rational surgical planning and technique selection. Recognition that deviation severity, cartilage quality, and the presence of concomitant deformities should guide approach selection has led to algorithm-based treatment strategies.</p><p><strong>Summary: </strong>Successful management requires thorough anatomical understanding, accurate classification of deviation type, and appropriate technique matching to pathology. A graduated surgical approach progressing from conservative remodelling to complex reconstruction optimizes outcomes while minimizing complications. No single technique addresses all deviation patterns; the modern surgeon must command multiple approaches and understand their respective indications, advantages, and limitations to achieve consistently favourable results.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"258-264"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693595","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}

{"title":"Modern methods of cartilaginous microtia reconstruction.","authors":"Debbie R Pan, Randall A Bly, Kathleen C Y Sie, Amit D Bhrany","doi":"10.1097/MOO.0000000000001135","DOIUrl":"10.1097/MOO.0000000000001135","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this manuscript is to review current literature of modern cartilaginous microtia reconstruction techniques and describe evolving biotechnological advancements within this field. We additionally offer opinions on technical refinements from our institutional experience with autologous rib cartilage reconstruction performed for nearly 30 years.</p><p><strong>Recent findings: </strong>Autologous rib cartilage reconstruction is the gold standard for microtia treatment. There is active research in developing alternative framework materials, including allogenic and tissue-engineered cartilage. Advancements in technology such as three-dimensional bioprinting play an increasing role in the personalization and precision of auricular reconstruction.</p><p><strong>Summary: </strong>Microtia reconstructive surgery presents a challenge in balancing aesthetic goals with minimal morbidity. Cartilage offers framework strength as well as pliability for custom shaping. Tissue-engineered cartilage for microtia is promising, prompting research in this field focused on elucidating long-term durability and safety. A robust understanding of cartilaginous options for auricular reconstruction in the context of modern evidence and technology can improve both patient and surgeon satisfaction.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"241-248"},"PeriodicalIF":1.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213629","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}

{"title":"Scaling community-based care for conductive hearing loss in low- and middle-income settings.","authors":"De Wet Swanepoel","doi":"10.1097/MOO.0000000000001116","DOIUrl":"10.1097/MOO.0000000000001116","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines recent advances in community-based care for conductive hearing loss in low- and middle-income countries (LMICs), focusing on developments that have materially shifted the feasibility of decentralized service delivery across prevencommution, screening and diagnosis, medical management, and rehabilitation.</p><p><strong>Recent findings: </strong>World Health Organization guidance now explicitly endorses task-sharing for primary ear and hearing care, including community health worker-facilitated hearing aid provision. Long-term follow-up from pneumococcal vaccination trials demonstrates sustained otitis media prevention and improved hearing outcomes 16-20 years postvaccination. Smartphone-based screening and diagnostic tools, including AI-assisted otoscopy and mobile tympanometry, are enabling accurate community-level identification without specialist infrastructure. Medical management of common conductive hearing loss (CHL) causes, including cerumen impaction and uncomplicated chronic suppurative otitis media, can be safely delivered by trained community health workers and primary care nurses. Community-based hearing aid provision achieves sustained rehabilitation outcomes comparable to specialist-led models across diverse LMIC settings.</p><p><strong>Summary: </strong>Recent evidence demonstrates that community-based CHL care is feasible, safe, and effective when supported by appropriate training, technology, and task-sharing frameworks. The primary constraint to scale is no longer technological feasibility but prioritisation within health planning and financing frameworks.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"211-217"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168138","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}

{"title":"The Copenhagen Model: Advancing multidisciplinary strategies for dysphagia and supportive care after head and neck cancer.","authors":"Irene Wessel, Tine Bloch Jensen","doi":"10.1097/MOO.0000000000001120","DOIUrl":"10.1097/MOO.0000000000001120","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights the growing need for coordinated, multidisciplinary survivorship models for individuals treated for head and neck cancer (HNC), as modern treatments have improved survival for the group but also led to a higher prevalence of complex, multisystem late sequelae. The importance of authorities and academic societies in incorporating rehabilitation as part of treatment in national cancer plans is reviewed. As healthcare systems strive to integrate hospital-based and community-based services, the balance between centralisation of specialisation and the desire for patient-centred care is challenged. The Copenhagen Model for HNC Rehabilitation, provides a structured and standardised framework for assessing patient needs, enhancing care coordination across sectors, and deliver specialised, patient-centred rehabilitation from the early postoperative period through late sequelae, salvage treatment, and advance care planning.</p><p><strong>Recent findings: </strong>Dysphagia remains one of the most frequent and burdensome late sequelae after treatment of HNC, contributing to impaired quality of life, airway protection problems, nutritional concerns, and emotional distress. The Copenhagen Model offers a structured model for managing late sequelae after surgically treated HNC by systematic patient stratification, home-based visits, and multidisciplinary efforts with comprehensive clinical assessments, identifying unmet rehabilitation needs and initiating interventions. This systematic approach has contributed to creating an increased focus on palliative care and advanced care planning and to a greater degree of refraining from treatment.</p><p><strong>Summary: </strong>Insights from this model suggest that structured, multidisciplinary team-based rehabilitation can enhance the detection of late effects, promote well tolerated and effective therapeutic strategies, and strengthen patient-centred outcomes in survivorship care. The clinical experience underscores the need for ongoing research to refine interventions, assess long-term functional outcomes, and optimise multidisciplinary collaboration in HNC rehabilitation. Additionally, patients' posttreatment experiences influence clinicians' perspectives on the scope of future treatments, underscoring the need for surgeons' participation in rehabilitation and importance of research into prehabilitation assessment and communication.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"179-184"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215106","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}

{"title":"Scaling early hearing detection in low-resource settings: evidence from recent pilots and policy implications.","authors":"Rachael Collins, Thomas Hampton, Wakisa Mulwafu","doi":"10.1097/MOO.0000000000001119","DOIUrl":"10.1097/MOO.0000000000001119","url":null,"abstract":"<p><strong>Purpose of review: </strong>Childhood hearing loss remains a major yet under-addressed public health challenge in low-income and middle-income countries (LMICs). Despite global policy momentum following the World Report on Hearing, early detection programmes remain fragmented, urban-centred, and difficult to scale. This review synthesizes evidence from recent newborn, infant, preschool, and school-age screening pilots (2024-2025) to clarify emerging models, persistent barriers, and policy implications for expanding equitable early hearing screening in resource-constrained settings.</p><p><strong>Recent findings: </strong>Recent studies demonstrate growing interest in community-based delivery, task-shifting to non-specialist health workers, and the use of portable and digital tools - including smartphone-based OAE, tablet screeners, and remote audiology services. Pilots across Africa and Asia show high feasibility and caregiver acceptability but reveal substantial challenges: limited diagnostic capacity, workforce shortages, high loss-to-follow-up, and uncertain programme costs. School-based and preschool screening programmes offer a critical second opportunity for detection, particularly for late-onset and infection-related hearing loss, and show strong potential when integrated into existing education or child-health platforms.</p><p><strong>Summary: </strong>Scalable early hearing detection in LMICs requires context-specific models, strengthened referral pathways, and sustainable financing. Digital tools and task-shifting offer promising avenues but need rigorous validation and integration into national systems. Future research should prioritize cost-effectiveness, culturally grounded family-centred approaches, and embedding screening within broader child-health policy frameworks.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"201-210"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357683","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}