Current Opinion in Otolaryngology & Head and Neck Surgery最新文献_第3页

Medial sural artery perforator flap in head & neck reconstruction. 腓肠内侧动脉穿支皮瓣在头颈部重建术中的应用。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-16 DOI: 10.1097/MOO.0000000000001055

Omar A Karadaghy, Allen L Feng

{"title":"Medial sural artery perforator flap in head & neck reconstruction.","authors":"Omar A Karadaghy, Allen L Feng","doi":"10.1097/MOO.0000000000001055","DOIUrl":"10.1097/MOO.0000000000001055","url":null,"abstract":"Purpose of review: This review focuses on the recent advancements in the application of the medial sural artery perforator (MSAP) flap for head and neck reconstruction. It highlights key anatomical findings, surgical techniques, comparative outcomes, and future perspectives from the last 1-3 years of research.Recent findings: The MSAP flap has emerged as a reliable option for head and neck reconstruction due to its thin, pliable nature and minimal donor-site morbidity. Recent anatomical studies have refined understanding of its vascular consistency, with perforators located 8-12 cm distal to the popliteal crease and pedicle lengths averaging 10.1 cm. Functional outcomes demonstrate superiority over bulkier alternatives such as the anterolateral thigh flap, particularly in intraoral reconstructions, while donor-site morbidity remains significantly lower than that of the radial forearm free flap.Summary: The MSAP flap provides an optimal balance of form and function for complex head and neck reconstructions. Its consistent anatomy and favorable postoperative outcomes underscore its growing role in modern reconstructive surgery. Further multicenter trials are essential to establish standardized protocols and enhance outcomes.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"206-210"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129629","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

Advances in facial fracture care in patients with zygomaticomaxillary complex fractures. 颧颌复合体骨折患者面部骨折护理进展。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-23 DOI: 10.1097/MOO.0000000000001052

William M Swift, Alexander P Marston, Travis T Tollefson

{"title":"Advances in facial fracture care in patients with zygomaticomaxillary complex fractures.","authors":"William M Swift, Alexander P Marston, Travis T Tollefson","doi":"10.1097/MOO.0000000000001052","DOIUrl":"10.1097/MOO.0000000000001052","url":null,"abstract":"Purpose of review: Zygomaticomaxillary complex (ZMC) fractures pose both functional and aesthetic challenges, requiring careful surgical planning to optimize outcomes while minimizing morbidity. Recent advancements in surgical planning, fixation strategies, and implant technology have refined the approach to ZMC fracture repair. This review highlights these developments and discusses their implications for surgical decision-making, emphasizing strategies that balance reduction accuracy with the least invasive intervention.Recent findings: Studies suggest that minimizing fixation points in properly selected ZMC fractures does not compromise patient satisfaction or postoperative symmetry. Intraoperative CT is increasingly utilized and has been shown to reduce unnecessary incisions and implants while improving reduction accuracy. Computer aided surgical planning has demonstrated improved surgical precision through preoperative planning, guiding plate placement, and enhancing anatomical symmetry. Additionally, patient specific implants (PSIs) have emerged as valuable tools in complex or revision cases, offering more precise reconstruction with reduced operative time. Augmented reality (AR) is a rapidly emerging technology that holds promise for surgical planning and navigation for ZMC fracture repair.Summary: Wider adoption of intraoperative CT has improved surgical assessment, while advances in computer aided surgical planning and patient specific implants continue to refine surgical workflows and outcomes. As technology evolves, future research should focus on optimizing cost-effectiveness and further integrating digital planning tools. AR, still in its preliminary stages, may represent a significant innovation in enhancing surgical precision and visualization during ZMC fracture repair.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"199-205"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018373","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

Advances in virtual surgical planning for free tissue transfer. 游离组织移植虚拟手术计划的研究进展。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/MOO.0000000000001059

Elisabeth E Hansen, Rosh K V Sethi

{"title":"Advances in virtual surgical planning for free tissue transfer.","authors":"Elisabeth E Hansen, Rosh K V Sethi","doi":"10.1097/MOO.0000000000001059","DOIUrl":"10.1097/MOO.0000000000001059","url":null,"abstract":"Purpose of review: This review seeks to describe the current state of virtual surgical planning (VSP) for head and neck free flap reconstruction, highlighting recent advancements, future directions, and outstanding limitations.Recent findings: Three-dimensional (3D)-printed plates have been shown to confer increased accuracy and lower fracture rate compared to hand-bent plates. Efforts are underway to optimize plate design for load bearing and dental rehabilitation. Preclinical work is investigating bioresorbable plate materials and 3D-bioprinting of composite materials using stem cell and tissue engineering technology. Advances in imaging and artificial intelligence may improve reconstructive planning. Use of robots and augmented reality may increase precision and intraoperative flexibility in the future. Cost of VSP remains a concern, but has shown to be offset by decreased operative time and in-house VSP, and will likely continue to fall as use of VSP increases. While numerous advantages have been shown for VSP, few studies have investigated correlation of VSP to patient-reported outcomes, which is an increasingly important metric.Summary: In addition to increasing accuracy, decreasing operative time, and facilitating complex reconstructions, VSP has the potential to harness advancements in reconstructive materials, imaging, and artificial intelligence to advance free flap reconstruction and improve patient outcomes.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"192-198"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129523","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

Use of the preepiglottic baton plate for treatment of tongue-based obstruction in newborns with Robin sequence. 会厌前棒板治疗新生儿舌基梗阻的Robin顺序。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-14 DOI: 10.1097/MOO.0000000000001056

Kathryn S Marcus, Andrew R Scott

{"title":"Use of the preepiglottic baton plate for treatment of tongue-based obstruction in newborns with Robin sequence.","authors":"Kathryn S Marcus, Andrew R Scott","doi":"10.1097/MOO.0000000000001056","DOIUrl":"10.1097/MOO.0000000000001056","url":null,"abstract":"Purpose of review: The purpose of this manuscript is to review the current literature regarding nonoperative strategies for management of upper airway obstruction (UAO) among infants with Robin sequence (RS). We evaluate and discuss recent advances, benefits, and challenges of preepiglottic baton plate (PEBP) use as an alternative to more invasive surgical interventions for RS in infancy.Recent findings: Over the last two decades, the use of an orthodontic appliance has become an increasingly popular nonoperative intervention for the treatment of RS in newborns. Among infants with isolated RS, PEBP placement has been proven effective in diminishing signs of upper airway obstruction, avoiding tracheostomy, and facilitating oral feeding. When compared side-by-side to proven surgical interventions, such as mandibular distraction osteogenesis (MDO), at least one study suggests that PEBP may be equally effective in treating infants with moderate UAO. In addition, PEBP utilization may result in improved feeding and growth outcomes compared to those reported among infants who undergo MDO.Summary: This article summarizes the current landscape of an evolving, nonoperative treatment option for neonatal tongue base obstruction, which, in the appropriate patient population, represents an exciting alternative to surgical management.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"236-241"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129630","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

Management of trismus after radiation therapy. 放射治疗后牙关的处理。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/MOO.0000000000001060

Emma Charters, Holly McMillan, Richard Cardoso

{"title":"Management of trismus after radiation therapy.","authors":"Emma Charters, Holly McMillan, Richard Cardoso","doi":"10.1097/MOO.0000000000001060","DOIUrl":"10.1097/MOO.0000000000001060","url":null,"abstract":"Purpose of review: The purpose of this review is to summarize the current management of radiation-induced trismus. It will provide an overview of radiation-induced trismus' pathophysiology, assessment, diagnosis, and treatment, along with directions for future research.Recent findings: Despite advances in radiation technology, the proximity of head and neck tumours to the masticatory muscles prevents shielding of these critical structures, increasing the risk of trismus. Trismus has been treated using various techniques including stretching and strengthening exercises in the rehabilitation setting that have resulted in improvements in mouth opening, however, the exercise approach in both research and clinical practice rarely accommodates an individual's goals and priorities. The effect of prophylactic trismus exercises during radiation can be challenging to measure, likely due to exercise adherence with the onset of treatment related toxicities. There is limited support from the literature as to its preventive efficacy. Recent papers provide direction for trismus exercises and devices which may offer greater capacity to individualize treatment and optimize both functional and quality of life outcomes.Summary: The incidence of radiation induced trismus is anticipated to rise along with that of head and neck cancers globally. Trismus carries significant functional and quality of life implications with known limitations and opportunities for optimizing its management.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"255-261"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129628","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

Strategies for obviation and management of trismus in oral cancer. 口腔癌中唇腭裂的预防和治疗策略。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-02 DOI: 10.1097/MOO.0000000000001045

Shamit Chopra, Ramandeep Kaur, Anubha Bharthuar

{"title":"Strategies for obviation and management of trismus in oral cancer.","authors":"Shamit Chopra, Ramandeep Kaur, Anubha Bharthuar","doi":"10.1097/MOO.0000000000001045","DOIUrl":"10.1097/MOO.0000000000001045","url":null,"abstract":"Purpose of review: Trismus (decreased mouth opening) is frequently associated with oral premalignant/malignant lesions, and also occurs in upto 40% of head neck cancer patients post radiation therapy. Trismus is associated with adverse functional and oncologic outcomes through impact on quality of life and posttreatment disease surveillance. Relevant literature is mostly retrospective and single author/institution- a review of the same would aid management of this complex multifactorial disorder.Recent findings: Newer innovations aim at obviation of trismus during treatment planning for head neck cancer, including radiological and serologic prediction, surgical/reconstructive modifications, and tailored radiation therapy with emphasis on sparing excessive treatment to masticatory apparatus.Rehabilitation of manifest treatment-associated trismus, on the other hand, begins with accurate assessment of etiology and extent. Treatments range from exercises and device-based interventions, novel reconstructive methods aimed at ensuring maximal interincisal opening while minimizing donor site morbidity, and ensuring compliance through monitored adherence and self-reporting.Summary: Trismus prevention and rehabilitation in oral cancer is a multistep sustained process necessitating inputs from several specialties. Personalized treatment and rehabilitation regimens should be incorporated at the outset and continued till at least one year post treatment completion, to ensure optimized outcomes.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"211-215"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996208","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

Navigating our global surgery waters. 在我们的全球手术水域航行。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-07-03 DOI: 10.1097/MOO.0000000000001061

David A Shaye

引用次数: 0

Techniques for maxillomandibular fixation: old and new. 上颌下颌固定技术：新旧。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-04-01 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":"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":"216-221"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","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

Management of traumatic auricular avulsion injury - partial and complete. 外伤性耳廓撕脱伤的处理-部分和完全。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1097/MOO.0000000000001054

Allison Goldberg, Rhorie Kerr

{"title":"Management of traumatic auricular avulsion injury - partial and complete.","authors":"Allison Goldberg, Rhorie Kerr","doi":"10.1097/MOO.0000000000001054","DOIUrl":"10.1097/MOO.0000000000001054","url":null,"abstract":"Purpose of review: Auricular avulsion injuries present complex reconstructive challenges due to the intricate three-dimensional (3D) structure and vascular supply of the ear. This review examines traditional and emerging techniques in auricular trauma repair, including microsurgical advancements, digital planning, tissue engineering, and 3D bioprinting, highlighting their impact on reconstructive outcomes.Recent findings: Traditional techniques, such as multilayer closure and microsurgical reattachment, remain foundational in auricular reconstruction. However, recent studies suggest that subtotal amputations with small vascular pedicles may survive without microvascular anastomosis. Microsurgical refinements, including digital planning and customized surgical guides, enhance precision in reconstruction. Tissue engineering innovations, such as 3D bioprinting with biomimetic scaffolds and magnetoresponsive hydrogels, show promise for auricular cartilage regeneration. Additionally, postoperative adjuncts like antipressure alarm systems and bioactive hydrogels seeded with stem cells improve healing and long-term outcomes.Summary: Auricular trauma repair is evolving through a combination of established and innovative techniques. Digital planning, microsurgical advancements, and tissue engineering are shaping a new era of patient-specific reconstruction. Future research should focus on refining these technologies, evaluating long-term efficacy, and addressing economic feasibility to optimize patient outcomes.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"262-265"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129537","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

Hyperbaric oxygen therapy for wounds of the face, head and neck. 高压氧治疗面部、头部及颈部伤口。

IF 1.9 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1097/MOO.0000000000001053

Peter W Kahng, Adeeb Derakhshan, Shekhar K Gadkaree

{"title":"Hyperbaric oxygen therapy for wounds of the face, head and neck.","authors":"Peter W Kahng, Adeeb Derakhshan, Shekhar K Gadkaree","doi":"10.1097/MOO.0000000000001053","DOIUrl":"10.1097/MOO.0000000000001053","url":null,"abstract":"Purpose of review: Wounds within the face, head, and neck region can have devastating aesthetic, functional, and potentially fatal outcomes for patients and often require multimodality treatment. Here we discuss the role of hyperbaric oxygen for a variety of wounds within the head and neck region and the clinically associated outcomes.Recent findings: Hyperbaric oxygen (HBO) treatment can be useful in the management of wounds and infections within the head and neck region. While there are few randomized controlled clinical trials evaluating the effectiveness of HBO therapy, there is a large amount of retrospective literature supporting its adjunctive role in the treatment of radiation associated head and neck wounds, compromised grafts and flaps, and necrotizing soft tissue infections. The most common treatment protocols are typically initiated at 2-2.4 atmosphere absolute (ATA) at 100% oxygen for 90 min for 30 daily sessions, though this varies significantly in the available literature. In the setting of osteoradionecrosis (ORN) and medication-induced osteonecrosis of the jaw (MRONJ), however, emerging treatments such as the Potentiation by Clodronate (PENTOCLO) protocol may provide more effective treatment that HBO therapy.Summary: Hyperbaric oxygen therapy should be considered as an adjuvant therapy for head and neck wounds involving radiated soft tissue, compromised local and free flaps, filler-induced soft tissue necrosis or blindness, and for necrotizing soft tissue infection; however, more randomized controlled trials are needed to better evaluate both their clinical impact as well as better establish treatment protocols, particularly in the setting of ORN and MRONJ.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"222-229"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129489","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