Annals of Otology, Rhinology & Laryngology最新文献

{"title":"Anterior Skull Base Reconstruction following Ablative Surgery for Osteoradionecrosis: Case Report and Review of Literature","authors":"Katya Chapchay, J. Weinberger, R. Eliashar, N. Adler","doi":"10.1177/0003489419865558","DOIUrl":"https://doi.org/10.1177/0003489419865558","url":null,"abstract":"Introduction: Osteoradionecrosis is one of many potentially severe complications of radiotherapy for nasopharyngeal carcinoma. Osteoradionecrosis of the skull base is life-threatening due to the critical proximity of the pathological process to vital structures, for example, the intracranial cavity, the upper spine, and major blood vessels. Reconstructive options following surgical debridement of the anterior skull base and upper spine osteonecrosis have been scarcely described in the literature. Case presentation and management: We present a rare case of osteoradionecrosis of the clivus and cervical vertebrae C1-C2 in a patient previously treated with chemoradiotherapy for nasopharyngeal carcinoma, presenting as severe soft tissue infection of the neck. Aggressive surgical debridement and reconstruction with a two-paddle free anterolateral thigh flap was performed using a combination of transcervical and transnasal endoscopic approaches. A novel endoscopic procedure in the sphenoid sinus enabled flap anchoring in this complex area. Discussion: Surgical modalities for osteoradionecrosis of the skull base and upper spine are discussed and review of the literature is presented. Conclusion: Reconstruction of the anterior skull base with a well-vascularized free flap following ablative surgery should be considered in management of life-threatening osteoradionecrosis of the area. Endoscopic opening of the sphenoid sinus and creating a funnel-shaped stem is a newly described technique that guarantees precise placement of the flap and is a valuable adjunct to the reconstructive armamentarium.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"128 1","pages":"1134 - 1140"},"PeriodicalIF":0.0,"publicationDate":"2019-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77774402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unsupervised Learning Techniques for the Investigation of Chronic Rhinosinusitis","authors":"A. Walker, P. Surda","doi":"10.1177/0003489419863822","DOIUrl":"https://doi.org/10.1177/0003489419863822","url":null,"abstract":"Objectives: This article reviews the principles of unsupervised learning, a novel technique which has increasingly been reported as a tool for the investigation of chronic rhinosinusitis (CRS). It represents a paradigm shift from the traditional approach to investigating CRS based upon the clinically recognized phenotypes of “with polyps” and “without polyps” and instead relies upon the application of complex mathematical models to derive subgroups which can then be further examined. This review article reports on the principles which underlie this investigative technique and some of the published examples in CRS. Methods: This review summarizes the different types of unsupervised learning techniques which have been described and briefly expounds upon their useful applications. A literature review of studies which have unsupervised learning is then presented to provide a practical guide to its uses and some of the new directions of investigations suggested by their findings. Results: The commonest unsupervised learning technique applied to rhinology research is cluster analysis, which can be further subdivided into hierarchical and non-hierarchical approaches. The mathematical principles which underpin these approaches are explained within this article. Studies which have used these techniques can be broadly divided into those which have used clinical data only and that which includes biomarkers. Studies which include biomarkers adhere closely to the established canon of CRS disease phenotypes, while those that use clinical data may diverge from the typical “polyp versus non-polyp” phenotypes and reflect subgroups of patients who share common symptom modifiers. Summary: Artificial intelligence is increasingly influential in health care research and machine learning techniques have been reported in the investigation of CRS, promising several interesting new avenues for research. However, when critically appraising studies which use this technique, the reader needs to be au fait with the limitations and appropriate uses of its application.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"43 1","pages":"1170 - 1176"},"PeriodicalIF":0.0,"publicationDate":"2019-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76490871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic Thymus: An Unusual Case of Subglottic Mass","authors":"Irene Paraboschi, F. Fati, F. Rizzo, O. Sacco, N. Stagnaro, G. Mattioli, A. Simonini, Oscar Mazzei, M. Torre","doi":"10.1177/0003489419863828","DOIUrl":"https://doi.org/10.1177/0003489419863828","url":null,"abstract":"Objectives: The aim of our study is to report a case of a child with subglottic thymus that was suspected during diagnostic work-up for severe airway obstruction, excised surgically and confirmed with final histopathological examination. Moreover, we performed a narrative literature review to outline clinical and diagnostic features of this rare condition and to report suggestions for the management of subglottic masses. Methods: We report the case of a 7-month-old boy who was admitted to our Pediatric Airway Team Unit due to a history of worsening biphasic stridor and recurrent episodes of upper airway obstruction. The successful diagnostic work-up and a narrative literature of analogous cases of subglottic thymus were reported. Results: Ectopic thymus is a very rare condition in which thymic tissue is found outside the normal pathway of its embryonic migration. It usually presents as a cystic or, more rarely, solid mass, showing an indolent course toward spontaneous involution. In some cases, however, it becomes symptomatic exerting compression on surrounding vital structures. Due to its rarity, the initial diagnosis is normally mistaken with inflammatory diseases or malignancies and the definitive diagnosis is only achieved after histological examination of the excised specimen. To our knowledge, only four other cases of subglottic ectopic thymic tissue have been reported in the English literature so far and the diagnosis has never been suspected preoperatively. Conclusion: It is mandatory to consider ectopic thymic tissue in the differential diagnosis in children presenting with airways obstruction in order to prevent unnecessary, extensive, and exploratory surgery.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"51 1","pages":"1182 - 1188"},"PeriodicalIF":0.0,"publicationDate":"2019-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74709613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients","authors":"Danny B. Jandali, Ashwin Ganti, I. Husain, P. Batra, B. Tajudeen","doi":"10.1177/0003489419861124","DOIUrl":"https://doi.org/10.1177/0003489419861124","url":null,"abstract":"Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"1 1","pages":"1129 - 1133"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88084531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral Tubed Supraglottoplasty: A New Minimally Invasive Procedure for Aspiration","authors":"Yue-bing Ma, M. Naunheim, Jill K Gregory, P. Woo","doi":"10.1177/0003489419862581","DOIUrl":"https://doi.org/10.1177/0003489419862581","url":null,"abstract":"Objectives: We describe a new procedure for aspiration called tubed supraglottoplasty (TS). TS is a transoral procedure that approximates the aryepiglottic (AE) folds and arytenoids. This narrows the laryngeal inlet. This procedure has been used to improve swallowing and reduce aspiration in patients with vocal fold paralysis. We describe the technical aspects of TS and report on 11 patients. Methods: TS is done by oral intubation followed by suspension laryngoscopy. An incision is made along the AE fold into the posterior commissure and then continued to the opposite AE fold. Dissection within this incision creates two mucosal flaps, one based on the laryngeal surface and the other on the pharyngeal surface. Two 1-cm releasing incisions are made at each end of the AE fold. The laryngeal mucosal flap is approximated using a 3-0 self-locking running suture. The pharyngeal mucosal flap is approximated as a second layer. This double-layered mucosal V-Y advancement flap builds up the posterior laryngeal height. It narrows and “tubes” the supraglottis. Results: All patients tolerated TS without airway complications. Ten of the 11 patients reported improved swallowing function with less aspiration. Six of the 8 patients with prior G-tubes had their gastrostomy tube removed. Postoperative laryngoscopy showed a narrowed “tubed” supraglottis with a higher posterior wall preventing spillover and aspiration. An improved Functional Oral Intake Scale was recorded in ten of eleven patients. Conclusion: TS is a minimally invasive procedure that can improve swallowing and reduce aspiration.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"56 1","pages":"1122 - 1128"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91307806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Make-Up Therapy for Patients With Facial Nerve Palsy","authors":"Keishi Fujiwara, Y. Furuta, W. Aoki, Y. Nakamaru, S. Morita, Kimiko Hoshino, Atsushi Fukuda, A. Homma","doi":"10.1177/0003489419841396","DOIUrl":"https://doi.org/10.1177/0003489419841396","url":null,"abstract":"Objectives: To investigate the effectiveness of make-up therapy for patients with facial nerve palsy. Methods: Seven female patients with facial nerve palsy who received specialist make-up therapy were enrolled. The objective of the make-up therapy was to obtain a symmetrical facial appearance. Results: Overall score for the Facial Clinimetric Evaluation (FaCE) scale was significantly improved after make-up therapy. There was a tendency for symptoms of depression to be improved among patients after make-up therapy. Conclusion: Make-up therapy to improve the symmetry of facial appearance could afford a noninvasive and low-cost treatment for patients with facial nerve palsy, especially in terms of patient quality of life and psychological condition.","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"17 4 1","pages":"721 - 727"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78128832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Thieme MedOne Otolaryngology","authors":"Danielle M. Bottalico","doi":"10.1177/0003489419851031","DOIUrl":"https://doi.org/10.1177/0003489419851031","url":null,"abstract":"This all-inclusive website represents a great resource for otolaryngology residents and practitioners alike. It features easy connectivity via web browsers and even mobile devices via the MedOne app. It provides access to more than 180 e-books, 6 Thieme-published e-journals, several case presentations with associated questions, and numerous procedures with step-by-step instructions. Users may also view and download over 70,000 images, videos, and audio via the media section. The book and e-journal section include educational material and references for every subspeciality of otolaryngology. The latest edition of Handbook of Otolaryngology serves as a quick, concise pocket reference for general otolaryngology. Another great reference is Head and Neck Trauma: An Interdisciplinary Approach, which is helpful for diagnosing and treating common head and neck traumatic injuries. Additionally, there is an excellent radiographic atlas, Imaging for Otolaryngologists, which reviews the imaging modality of choice for various pathologies. The e-journal section is less expansive, but provides access to International Archives of Otolaryngology, Annals of Otology and Neurotology, Journal of Neurological Surgery Part B Skull Base, as well as 3 others. As a junior resident, I found the cases and procedures sections invaluable. Cases are organized into 14 subspecialties. Each subspecialty includes multiple topics with a total of nearly 100 case examples. There is a search bar where you can specify the topic of interest. Each case starts with a presentation and then discusses the differential diagnosis, medical, and surgical management as well as recommendations for follow-up. At the end, questions reinforce learning, and suggested readings further elucidate the topic discussed. Procedures are similarly organized with more than 100 detailed procedures. Each procedure begins by explaining the surgical principle, indications, contraindications, and informed consent before detailing the surgical technique with supporting images. Every procedure concludes with postoperative care. Indications for certain procedures are more detailed than others, but overall the procedure section is very comprehensive. Moreover, MedOne Otolaryngology offers an overwhelming number of resources in one organized, userfriendly platform. Users have the ability to personalize the website by selecting frequently accessed topics as a favorite for quick reference. Additionally, being able to access this platform from a mobile device adds to the convenience of this interface. Regardless of one’s level of training, this website offers educational material for all. 851031 AORXXX10.1177/0003489419851031Annals of Otology, Rhinology & LaryngologyBook Review book-review2019","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"28 1","pages":"984 - 984"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82559482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Clinical Esophagology and Transnasal Esophagoscopy","authors":"M. Lerner","doi":"10.1177/0003489419851032","DOIUrl":"https://doi.org/10.1177/0003489419851032","url":null,"abstract":"","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"31 1","pages":"983 - 983"},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75904046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Rapid Interpretation of Balance Function Tests, First Edition","authors":"Juliette O Flam","doi":"10.1177/0003489419836746","DOIUrl":"https://doi.org/10.1177/0003489419836746","url":null,"abstract":"Rapid Interpretation of Balance Function Tests provides a review of vestibular physiology and pathology followed by an overview of diagnostic vestibular testing before diving into the specifics of individual tests. Illustrations, flow diagrams, summary tables, and sample test results are provided throughout, thereby strengthening important concepts and allowing one to not only understand but also interpret balance function tests. An accompanying DVD also demonstrates the eye movements associated with those tests. The book provides an overview of balance function tests but does not provide any clinical vignettes, making it difficult for an otolaryngologist in training to understand which balance function tests are most relevant when assessing individual patients. In that sense, this book is more geared toward otolaryngologists in practice and other health care professionals who wish to gain more insight into the interpretation of balance function tests. 836746 AORXXX10.1177/0003489419836746Annals of Otology, Rhinology & LaryngologyBook Review book-review2019","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"61 1","pages":"782 - 782"},"PeriodicalIF":0.0,"publicationDate":"2019-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88808287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Neck Dissection","authors":"Karen Y Choi","doi":"10.1177/0003489419842086","DOIUrl":"https://doi.org/10.1177/0003489419842086","url":null,"abstract":"Neck Dissection is a comprehensive text that reviews the preoperative workup and anatomy, surgical considerations and techniques, and postoperative recovery and rehabilitation of patients undergoing neck dissections. There are a total of 28 chapters that cover the assessment of cervical lymphadenopathy and anatomy as well as surgical techniques of the neck dissections of all levels and indications for each surgery. This text also covers adjuvant treatment considerations as well as novel techniques such as sentinel node dissection and robotic neck dissection. Each chapter is clearly outlined with nice flow of content and high-quality intraoperative photos highlighting anatomical landmarks as well as clear illustrations and tables that expertly supplement the text. Furthermore, each chapter ends with a comprehensive list of citations as an additional resource to the reader. This text is a wonderful resource for head and neck surgeons at all levels of training. It provides a thorough review of the anatomy with both illustrations and intraoperative photos that nicely bridge textbook learning with hands-on experience. The subject matter is a good combination of practical clinical knowledge and academic evidence-based literature, which is presented in a manner that makes it easy to digest. This text will serve as a nice adjunct to other anatomy texts and surgical atlases. 842086 AORXXX10.1177/0003489419842086Annals of Otology, Rhinology & LaryngologyBook Review book-review2019","PeriodicalId":8361,"journal":{"name":"Annals of Otology, Rhinology & Laryngology","volume":"29 1","pages":"783 - 783"},"PeriodicalIF":0.0,"publicationDate":"2019-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87907156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}