Current Opinion in Otolaryngology & Head and Neck Surgery最新文献_第8页

Emerging findings for the assessment and treatment of pediatric deep neck abscesses. 儿科深颈部脓肿评估和治疗的新发现。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI: 10.1097/MOO.0000000000000937

Paul Bryan Hankey, Meghan Tracy, Jill M Arganbright

{"title":"Emerging findings for the assessment and treatment of pediatric deep neck abscesses.","authors":"Paul Bryan Hankey, Meghan Tracy, Jill M Arganbright","doi":"10.1097/MOO.0000000000000937","DOIUrl":"10.1097/MOO.0000000000000937","url":null,"abstract":"Purpose of review The purpose of this review is to summarize new literature regarding the description, diagnosis, and treatment of pediatric deep neck abscesses. Recent findings Providers should include multi-inflammatory syndrome in children (MIS-C) in a differential diagnosis in children suspected of having a retropharyngeal abscess. MRI may guide the proper management of children with deep neck abscesses by more accurately detecting free fluid compared to computed tomography imaging. Factors that may predict the need for surgical management include elevations in white blood cell counts and abscess size more than 3 cm. However, future investigation is necessary to establish consistent guidelines. Medical management is effective in many children, with a new study indicating success using a combination of cefotaxime and rifampicin. Summary Anatomical and age-related risk factors predispose children to the development of deep neck abscesses. Findings from recent studies may aid providers in making an accurate diagnosis and providing proper medical or surgical management of children with these infections.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220705","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. 编辑介绍。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1097/MOO.0000000000000939

引用次数: 0

Large-data contextualizations of social determinant associations in pediatric head and neck cancers. 儿童头颈癌社会决定因素关联的大数据背景分析。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-09-14 DOI: 10.1097/MOO.0000000000000931

David J Fei-Zhang, Daniel C Chelius, Anthony M Sheyn, Jeff C Rastatter

{"title":"Large-data contextualizations of social determinant associations in pediatric head and neck cancers.","authors":"David J Fei-Zhang, Daniel C Chelius, Anthony M Sheyn, Jeff C Rastatter","doi":"10.1097/MOO.0000000000000931","DOIUrl":"10.1097/MOO.0000000000000931","url":null,"abstract":"Purpose of review: Prior investigations in social determinants of health (SDoH) and their impact on pediatric head and neck cancers are limited by the narrow scope of cancer types and SDoH being studied while lacking inquiry on the interrelational contribution of varied SDoH in real-world contexts. The purpose of this review is to discuss the current research tackling these shortcomings of SDoH-based studies in head and neck cancer and to discuss means of applying these findings in prospective initiatives and implementations.Recent findings: Through leveraging contemporary, large-data analyses measuring diverse social vulnerabilities, several studies have identified comprehensive delineations of which social disparities contribute the largest quantifiable impact on the care of head and neck cancer patients. Progressing from prior SDoH-based research of the decade, these studies contextualize the effect of social vulnerabilities and have laid the foundations to begin addressing these issues in the complex, modern-day environment of interrelatedsocial factors.Summary: Social determinants of health markedly affect pediatric head and neck cancer care and prognosis in complex and surprising ways. Modern-day tools and analyses derived from large-data techniques have unveiled the quantifiable underpinnings of how SDoH impact these pathologies.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609998","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: 1

The development of a pediatric skull base team: how, where and why? 儿科颅底团队的发展：如何、在哪里以及为什么？

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-09-13 DOI: 10.1097/MOO.0000000000000930

Joseph Lee, Jeffrey Leonard, Patrick Walz

{"title":"The development of a pediatric skull base team: how, where and why?","authors":"Joseph Lee, Jeffrey Leonard, Patrick Walz","doi":"10.1097/MOO.0000000000000930","DOIUrl":"10.1097/MOO.0000000000000930","url":null,"abstract":"Purpose of review: The purpose of this review is to describe the development of pediatric skull base surgical techniques and illustrate the advantages of pediatric endonasal skull base surgery (ESBS) when applied in appropriate settings. Additionally, this manuscript endeavors to define the pediatric skull base team components, highlight circumstances amenable to the development of a pediatric skull base surgery team, and describe the relative advantages of independent pediatric teams versus incorporation with adult skull base practices.Recent findings: Multiple series published within the last decade have described the application of ESBS to the pediatric population, demonstrating adoption of these interventions in many academic centers. Most series include relatively small numbers of patients, highlighting the relative infrequency of anterior skull base pathology in the pediatric patient. Given the relatively low volume and high technical demands of this skillset, general guidelines for the timing, suggested training, and volume necessary to support a pediatric skull base team are offered.Summary: The interest in pediatric ESBS continues to expand though case volumes may limit maintenance of skills in lower volume centers. The development of a dedicated pediatric skull base team in areas where sufficient volume exists facilitates concentration of expertise and interdisciplinary relationships necessary to provide the highest level of care. Collaborating with adult skull base teams can enhance the pediatric team experience, increasing exposure to complex surgical planning and radiologic nuances. However, a pediatric-focused skull base team can tailor treatment to meet the specific psychosocial and developmental needs of children.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242318","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

Esophageal motility disorder - has Chicago classification v4.0 simplified our management? 食管运动障碍-芝加哥分类v4.0是否简化了我们的管理？

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-04 DOI: 10.1097/MOO.0000000000000936

Francis Edeani, Benson Massey

{"title":"Esophageal motility disorder - has Chicago classification v4.0 simplified our management?","authors":"Francis Edeani, Benson Massey","doi":"10.1097/MOO.0000000000000936","DOIUrl":"10.1097/MOO.0000000000000936","url":null,"abstract":"Review purpose: Addressing dysphagia is vital due to its prevalence and impact on healthcare expenditure. While high resolution manometry (HRM) effectively evaluates esophageal dysphagia, its role in oropharyngeal dysphagia and upper esophageal sphincter (UES) dysfunction remains debated. The fourth iteration of the Chicago classification (CC) offers an algorithmic approach for diagnosing abnormal motor patterns via HRM. This review assesses the CC's impact on dysphagia management.Recent insights: The Chicago classification version 4.0 emphasizes auxiliary and provocative techniques when the algorithm falls short of a conclusive diagnosis. It introduces stricter criteria for previously ambiguous conditions like ineffective motility and esophagogastric junction outflow obstruction. This version also introduces the concept of conclusive and inconclusive classifications based on symptoms, provocation maneuvers, and supportive testing minimizing ambiguity.Summary: The Chicago classification v4.0 remains a useful tool for the diagnosis of well characterized esophageal motility disorders. However, major limitations include reliance on HRM and a focus on distal esophagus contractile characteristics without considering proximal esophagus or upper esophageal sphincter, both of which can sometimes be the only evident abnormality in patients with dysphagia. Despite efforts to reduce ambiguity, diagnostic challenges persist. These limitations can be addressed in future updates.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220706","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

Total lower lip reconstruction: a review of recent advances. 全下唇重建术：近期进展综述。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-12 DOI: 10.1097/MOO.0000000000000926

Aishwarya Shukla, Kelsey Loy, G Nina Lu

引用次数: 0

Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia. 耳鼻咽喉科和头颈外科的最新观点：耳鼻喉科医生在儿童吞咽困难治疗中的作用。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-11 DOI: 10.1097/MOO.0000000000000934

Annie Farrell, Nikhila Raol

{"title":"Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia.","authors":"Annie Farrell, Nikhila Raol","doi":"10.1097/MOO.0000000000000934","DOIUrl":"10.1097/MOO.0000000000000934","url":null,"abstract":"Purpose of review: Dysphagia affects at least 1% of the pediatric population. This prevalence further increases in patients who are born prematurely or who have underlying neuromuscular or cardiopulmonary disorders. A multidisciplinary team approach, including an Otolaryngologist, can help promote an expedited diagnosis and therapeutic regimen, ensuring that the patient receives adequate nutrition needed for growth and development.Recent findings: The development and growth of multidisciplinary aerodigestive clinics have improved outcomes in pediatric patients with dysphagia. If a structural concern is noted on examination, there remain a multitude of medical and surgical options to help improve patient outcomes and swallow. These treatment options are usually multimodality and specific interventions may be employed to target a specific and notable abnormality.Summary: Pediatric dysphagia is a complex concern. For the otolaryngologist, etiologies with surgical targets may include ankyloglossia, tonsillar hypertrophy, laryngomalacia, laryngo-esophageal cleft, vocal fold movement impairment, and cricopharyngeal achalasia. The development and formalization of a multidisciplinary approach has streamlined and broadened treatment options for these patients. An otolaryngologist is integral as part of the treatment team of these patients.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220704","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

Realities and challenges of head and neck free flap reconstruction in sub-Saharan Africa. 撒哈拉以南非洲地区头颈部游离皮瓣重建的现实和挑战。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-09-18 DOI: 10.1097/MOO.0000000000000932

Samuel Okerosi, Aslam Nkya, Johan Fagan, Mary Jue Xu

{"title":"Realities and challenges of head and neck free flap reconstruction in sub-Saharan Africa.","authors":"Samuel Okerosi, Aslam Nkya, Johan Fagan, Mary Jue Xu","doi":"10.1097/MOO.0000000000000932","DOIUrl":"10.1097/MOO.0000000000000932","url":null,"abstract":"Purpose of review: With an increased need to decentralize and train more head and neck ablative and reconstructive surgeons in sub-Saharan Africa, we assess the realities and challenges of free flap reconstruction in sub-Saharan Africa to provide context of its use as a reconstructive option.Recent findings: Head and neck free flap reconstruction has been performed by local teams as well as visiting teams in Sub Saharan Africa with good results. Free flap success rates are similar to high income regions at 89% vs. 85-100%. However, flap salvage rates are significantly lower (45% compared to 64.1% reported in high income regions). This has been attributed to resource constraints.Summary: With increasing efforts to increase free flap reconstructive capacity in sub-Saharan Africa, these efforts need to be in the context of available healthcare resources including infrastructure and workforce outside of the surgical team. As training of head and neck ablative and reconstructive surgeons is expanded, reconstructive training needs take the healthcare resource availability into account.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220733","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

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population. 儿科人群中颈面部非结核分枝杆菌感染的治疗现状。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-09-12 DOI: 10.1097/MOO.0000000000000927

Keshav V Shah, Lazaro R Peraza, Joshua P Wiedermann

{"title":"Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population.","authors":"Keshav V Shah, Lazaro R Peraza, Joshua P Wiedermann","doi":"10.1097/MOO.0000000000000927","DOIUrl":"10.1097/MOO.0000000000000927","url":null,"abstract":"Purpose of review: The purpose of this review is to analyze and consolidate recently published literature to provide updated guidelines on the diagnosis and management of nontuberculous mycobacterial lymphadenitis (NTM LAD) in the pediatric population and to suggest areas of further research.Recent findings: Diagnosis of NTM LAD relies on a detailed clinical history, physical examination, laboratory tests, and imaging techniques. Treatment strategies vary widely, with a shift towards complete surgical excision being observed due to its higher cure rate, improved aesthetic outcomes, and lower recurrence rates. However, patient-specific factors must be considered. The role of genetic factors, such as Mendelian susceptibility to mycobacterial disease (MSMD), is being increasingly recognized and could lead to targeted therapies.Summary: Despite strides in the understanding and management of NTM LAD, substantial gaps remain in key areas such as the role of diagnostic imaging, optimal treatment parameters, postoperative care, and surveillance strategies. In this article, we explain our approach to NTM using the most relevant evidence-based medicine while offering directions for future work.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242317","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

Dysphagia and dementia: a 'double dilemma'. 吞咽困难和痴呆：“双重困境”。

IF 1.6 4区医学

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2023-12-01 Epub Date: 2023-08-02 DOI: 10.1097/MOO.0000000000000912

Rebecca Leonard

{"title":"Dysphagia and dementia: a 'double dilemma'.","authors":"Rebecca Leonard","doi":"10.1097/MOO.0000000000000912","DOIUrl":"10.1097/MOO.0000000000000912","url":null,"abstract":"Purpose of review: Dementia and its variants, including Alzheimer's disease, become more prevalent with age. Dysphagia, that is, difficulty swallowing, also occurs with aging, and is often associated with dementia. Currently, there is no cure for dementia, and dysphagia, unrecognized or untreated, can have life-altering, even fatal consequences. Prolonged ability to eat safely and effectively could contribute to improved quality of life in a fragile population. In this review, difficulties associated with the management of dysphagia in individuals with dementia, as well as promising possibilities for continued investigation, will be discussed.Recent findings: Recent reports point to unique problems related to understanding the comorbidities of dysphagia and dementia. These include delays in identifying dysphagia in affected individuals, as well as a lack of prevalence data for dysphagia in types and stages of dementia, or according to setting, for example, residential center, hospital. Emphasis on new tools, and new applications of existing tools, are needed.Summary: New evidence not only underscores complexities and shortcomings of our understanding of dysphagia in dementia but also points to existing applications with potential for improving the situation, and new investigational directions that may elaborate our further understanding of these comorbidities.","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10303552","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