Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy. This review contains 13 figures, 7 tables and 49 references. Key Words: LPR, GERD, PPI, RSI, TLESR
{"title":"Laryngopharyngeal Reflux and GERD","authors":"S. Dhar, L. Akst","doi":"10.2310/ot.7061","DOIUrl":"https://doi.org/10.2310/ot.7061","url":null,"abstract":"Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy.\u0000This review contains 13 figures, 7 tables and 49 references.\u0000Key Words: LPR, GERD, PPI, RSI, TLESR","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"233 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132944082","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}
A functional swallow involves the neuromuscular coordination of ingestion and digestion of food. Dysphagia is the term for abnormal swallowing, a discoordination of respiration, phonation, and digestion. Swallowing disorders can describe a simple abnormal sensation of swallow or a complex disorder leading to aspiration pneumonia. The most common cause of mortality and morbidity in dysphagia patients is aspiration pneumonia. Additional complications include malnutrition and dehydration. The prevalence of oropharyngeal dysphagia is up to 40% in adults over 65 and increases to 60% in institutionalized elderly. Oropharyngeal dysphagia is common after stroke, Parkinson’s disease, and other neurologic disorders. Patients in high-risk groups and patients with signs and symptoms of dysphagia should be diagnosed appropriately to determine underlying cause and aspiration risk. This chapter will focus on dysphagia due to pharyngeal phase disorders and their diagnosis and treatments. This review contains 6 figures, 4 videos, 5 tables and 49 references. Key Words: dysphagia, swallowing, Zenker diverticulum, modified barium swallow, videofluoroscopic swallowing study, FEES, transnasal esophagoscopy, esophagram
{"title":"Swallowing Disorders and Cricopharyngeal Dysfunction","authors":"R. Howell, Briana Vamosi","doi":"10.2310/ot.7062","DOIUrl":"https://doi.org/10.2310/ot.7062","url":null,"abstract":"A functional swallow involves the neuromuscular coordination of ingestion and digestion of food. Dysphagia is the term for abnormal swallowing, a discoordination of respiration, phonation, and digestion. Swallowing disorders can describe a simple abnormal sensation of swallow or a complex disorder leading to aspiration pneumonia. The most common cause of mortality and morbidity in dysphagia patients is aspiration pneumonia. Additional complications include malnutrition and dehydration. The prevalence of oropharyngeal dysphagia is up to 40% in adults over 65 and increases to 60% in institutionalized elderly. Oropharyngeal dysphagia is common after stroke, Parkinson’s disease, and other neurologic disorders. Patients in high-risk groups and patients with signs and symptoms of dysphagia should be diagnosed appropriately to determine underlying cause and aspiration risk. This chapter will focus on dysphagia due to pharyngeal phase disorders and their diagnosis and treatments. \u0000This review contains 6 figures, 4 videos, 5 tables and 49 references.\u0000Key Words: dysphagia, swallowing, Zenker diverticulum, modified barium swallow, videofluoroscopic swallowing study, FEES, transnasal esophagoscopy, esophagram ","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114749714","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}
Allergic rhinitis is a common condition that affects 10-40% of adults in the United States annually. It has a significant impact on patient quality of life and poses a substantial economic burden on society. Knowledge regarding accurate diagnosis, testing and treatment options are important in the management of this prevalent condition. Treatment options include allergen avoidance, pharmacotherapy and allergy immunotherapy. This review contains 7 figures, 6 tables and 28 references. Key words: allergic rhinitis, rhinorrhea, nasal congestion, intranasal corticosteroids, antihistamines, skin prick allergy testing, intradermal allergy testing, subcutaneous immunotherapy, sublingual immunotherapy, anaphylaxis
{"title":"Allergic Rhinitis","authors":"Sonya Marcus","doi":"10.2310/ot.7045","DOIUrl":"https://doi.org/10.2310/ot.7045","url":null,"abstract":"Allergic rhinitis is a common condition that affects 10-40% of adults in the United States annually. It has a significant impact on patient quality of life and poses a substantial economic burden on society. Knowledge regarding accurate diagnosis, testing and treatment options are important in the management of this prevalent condition. Treatment options include allergen avoidance, pharmacotherapy and allergy immunotherapy.\u0000This review contains 7 figures, 6 tables and 28 references.\u0000Key words: allergic rhinitis, rhinorrhea, nasal congestion, intranasal corticosteroids, antihistamines, skin prick allergy testing, intradermal allergy testing, subcutaneous immunotherapy, sublingual immunotherapy, anaphylaxis\u0000","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115174564","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}
Upper aerodigestive tract trauma is rare occurrence, but can have devastating consequences. Immediate complications including airway compromise can be life threatening and complicate resuscitative efforts. Long-term sequelae can significantly affect a patient’s quality of life by limiting one’s ability to breathe, phonate, and/or swallow. This review provides an overview of upper aerodigestive trauma, where many of these injuries occur concomitantly, but this text is divided into three main categories of: laryngeal framework, upper aerodigestive perforation, and adult caustic ingestion. The initial management of these injuries can be reflexive and mundane, but also are frequently nuanced and challenging, where personal experiences in management of these patients results in mastery. This review contains 9 figures, 4 tables and 82 references. Keywords: Laryngeal trauma, laryngeal facture, esophageal perforation, caustic ingestion
{"title":"Trauma of the Larynx and Cervical Esophagus","authors":"D. Young, Andrew Tkaczuk","doi":"10.2310/ot.7067","DOIUrl":"https://doi.org/10.2310/ot.7067","url":null,"abstract":"Upper aerodigestive tract trauma is rare occurrence, but can have devastating consequences. Immediate complications including airway compromise can be life threatening and complicate resuscitative efforts. Long-term sequelae can significantly affect a patient’s quality of life by limiting one’s ability to breathe, phonate, and/or swallow. This review provides an overview of upper aerodigestive trauma, where many of these injuries occur concomitantly, but this text is divided into three main categories of: laryngeal framework, upper aerodigestive perforation, and adult caustic ingestion. The initial management of these injuries can be reflexive and mundane, but also are frequently nuanced and challenging, where personal experiences in management of these patients results in mastery. \u0000This review contains 9 figures, 4 tables and 82 references. \u0000Keywords: Laryngeal trauma, laryngeal facture, esophageal perforation, caustic ingestion","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122013742","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}
As the structure of the ear is made of little more than cartilage, a limited blood supply, and a thin layer of skin, trauma in this area can easily manifest from a variety of causes. Some common examples of trauma involve laceration, piercing (intentional or otherwise), infection causing chondritis, blunt trauma causing necrosis, rupture of the tympanic membrane, perforation of the ear drum, and acoustic trauma that may result in hearing disorders such as tinnitus and high-frequency hearing loss. Acute hearing loss shows in two forms: conductive hearing loss and sensorineural hearing loss, the latter of which is caused by damage to the anatomic or neurologic structures of the ear dedicated to hearing. Sensorineural hearing loss generally has a poor prognosis and mandates prompt referral to an otolaryngologist. This review contains 4 figures, 13 tables, and 32 references. Keywords: Ear, auricular canal, trauma, otitis media, otitis externa, hearing loss, mastoiditis, cerumen, impaction
{"title":"Imaging of the Temporal Bone","authors":"P. Pruitt","doi":"10.2310/OT.4366","DOIUrl":"https://doi.org/10.2310/OT.4366","url":null,"abstract":"As the structure of the ear is made of little more than cartilage, a limited blood supply, and a thin layer of skin, trauma in this area can easily manifest from a variety of causes. Some common examples of trauma involve laceration, piercing (intentional or otherwise), infection causing chondritis, blunt trauma causing necrosis, rupture of the tympanic membrane, perforation of the ear drum, and acoustic trauma that may result in hearing disorders such as tinnitus and high-frequency hearing loss. Acute hearing loss shows in two forms: conductive hearing loss and sensorineural hearing loss, the latter of which is caused by damage to the anatomic or neurologic structures of the ear dedicated to hearing. Sensorineural hearing loss generally has a poor prognosis and mandates prompt referral to an otolaryngologist. This review contains 4 figures, 13 tables, and 32 references. Keywords: Ear, auricular canal, trauma, otitis media, otitis externa, hearing loss, mastoiditis, cerumen, impaction","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133626049","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}
Cough is one of the most common complaints that brings patients to seek medical attention, resulting in 30 to 50 million visits annually. Cough can be divided into three categories based on chronicity: namely acute, subacute, and chronic. Treatment of cough depends on the chronicity and etiology of the cough. Similarly, hemoptysis is a common occurrence, albeit less frequent than cough. Like cough, the treatment is dependent on etiology. Hemoptysis must always be taken seriously as death may occur from massive hemoptysis and result from asphyxiation. Whenever possible, attempts must be made to control massive hemorrhage by interventional techniques. This review contains 6 figures, 3 tables, and 69 references. Keywords: Cough, Hemoptysis, Smoking, Chest pain, GERD, Asthma, Hemorrhage, mucus, tracheoinnominate
{"title":"Cough and Hemoptysis","authors":"S. Andaz, S. Danovich","doi":"10.2310/surg.2041","DOIUrl":"https://doi.org/10.2310/surg.2041","url":null,"abstract":"Cough is one of the most common complaints that brings patients to seek medical attention, resulting in 30 to 50 million visits annually. Cough can be divided into three categories based on chronicity: namely acute, subacute, and chronic. Treatment of cough depends on the chronicity and etiology of the cough. Similarly, hemoptysis is a common occurrence, albeit less frequent than cough. Like cough, the treatment is dependent on etiology. Hemoptysis must always be taken seriously as death may occur from massive hemoptysis and result from asphyxiation. Whenever possible, attempts must be made to control massive hemorrhage by interventional techniques.\u0000This review contains 6 figures, 3 tables, and 69 references.\u0000Keywords: Cough, Hemoptysis, Smoking, Chest pain, GERD, Asthma, Hemorrhage, mucus, tracheoinnominate","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126858738","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}
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