World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

Objectives: Radiation-induced rhinosinusitis is a vital dose-limiting reaction in patients with head and neck malignancy. Unlike oral mucositis during or after radiotherapy, radiation-induced sinusitis is easily overlooked in clinical practice and rarely included in experimental studies. Herein, we review the literature to date on radiation-induced rhinosinusitis.

Methods: Relevant studies published between 1995 and 2022 were determined through a detailed search using open keywords from PubMed, with manual search of the reference list of the identified articles. Keywords searched were "ionizing radiation," "radiotherapy," "intensity-modulated radiotherapy," "head and neck tumor," "nasopharyngeal carcinoma," "nasal epithelium," "radiation damage," and "radiation-induced rhinosinusitis." Full-text articles that clearly stated the pathogenesis, clinical manifestation, predictors, treatment, and prognosis of radiation-induced rhinosinusitis were included.

Results: Radiation-induced rhinosinusitis occurs during radiotherapy and can last for months or even years after radiotherapy. A mixture of cellular outcomes caused by ionizing radiation and persistent damage of the epithelial and submucosal tissues after the treatment result from the radiotherapy itself. Endoscopic sinus surgery improves symptoms but can be accompanied by intraoperative and postoperative complications. Nasal irrigation, steroids, and antibiotics appear to reduce inflammation and relieve symptoms to a certain extent. Studies on other potentially useful drugs are underway and in the exploration stage, without clinical application.

Conclusions: Despite its high incidence, radiation-induced rhinosinusitis is a type of dose-limiting toxicity that theoretically does not produce fatal effects at controlled doses and with adequate follow-up care. In moderate-to-severe cases, toxicity may be present. Currently, radiation-induced rhinosinusitis has potential prevention and treatment strategies. However, no unified management protocol has shown significant improvement in radiation-induced rhinosinusitis. Further research is necessary.

Objective: The objective of this study is to provide a state-of-the-art review on the use of anesthetics for in-office facial plastic procedures.

Methods: A search was performed on PubMed, Embase, Web of Science, and Cochrane Review using the keywords "anesthesia," "office-based procedures," "local anesthesia," "facial plastics," "oral sedation," "moderate sedation," and "deep sedation."

Results and conclusions: Over the past few decades, the shift toward in-office invasive procedures has increased patient convenience and decreased hospital resource utilization. Many tools exist to reduce patient anxiety and discomfort in an office-based setting. With proper patient selection and technique, facial plastic surgeons can adequately anesthetize patients to perform Mohs reconstruction, cutaneous excisions, blepharoplasty, face-lifts, and other in-office procedures.

Objective: This present study investigated the prevalence, characteristics, and management of ear, nose, and throat (ENT) foreign body (FB) in the pediatric population of Tamale.

Study design: Retrospective observational study for otorhinolaryngology surgeries from 2019 to 2022 for children aged 17 years and below at Tamale Teaching Hospital.

Methods: A checklist created was used to collect data from the Otorhinolaryngology Surgeries records from 2019 to 2022. Chi-square and binary logistics regression analysis were done for associations. The level of statistical significance was set at 0.05.

Results: Two hundred and sixty-three cases were included in this study, and the mean age of the study participants was (4.3 ± 3.8) years with a minimum age of 1 month and a maximum age of 17 years. Most (65.4%) of the study participants were under-5 years. The prevalence of FB in this study was 47.9%. The majority (54.8%) of the ENT FB incidence was through ingestion. Almost half (50.8%) of the ENT FB was removed through esophagoscopy. Among the foreign bodies, the coin was the most common (44.5%). Those less than 1 year were more likely to encounter FB than those 12 years and above (adust odds ratio [AOR] = 27.7, 95% confidence interval [CI] = 4.7-164.6). Again, those of 5 to less than 12 years were more likely to encounter ENT FB than those 12 years and above (AOR = 5.7, 95% CI = 1.2-26.3).

Conclusions: Foreign bodies are a common occurrence in pediatric otorhinolaryngology surgeries in Tamale Teaching Hospital. Younger children are more likely to report for otorhinolaryngology surgeries for FB in Tamale Teaching Hospital.

Office-based procedures can be a fulfilling part of the facial plastic practice with the right tools, personnel, and preparation. Equipping the clinic for office-based procedures has several unique considerations that ultimately impact its success. It is important to strategize preemptively regarding what treatments will be offered and the respective equipment that will allow the safe, cost-effective, and high-quality delivery of those treatments. Most procedures in the office-based setting are cosmetic in nature and there are often overlapping treatment modalities that target similar outcomes. Patient selection and counseling is a crucial step in preparing for office-based procedures in the effort to maximize patient satisfaction. Nearly all the most common facial plastic procedures can be delivered in the office-based based setting under local anesthesia and moderate sedation, depending on the expertise of the surgeon. To enable these and other categories of treatments, there are certain expensive pieces of technology that one might consider for their office-based practice and other fundamental supplies that are necessary for almost all practices. Though the initial investment in equipment can be costly, this article also discusses more affordable alternatives or third-party sales of devices and equipment. The field of facial plastic surgery is very dynamic and having both peer and mentorship networks is invaluable in navigating some of the financial decisions discussed herein. This article also briefly covers personnel, training, and accreditation considerations.

Objective: The aim of this review article is to discuss the currently available facial fillers, their differences and indications, relevant anatomy, injection techniques, and avoidance and management of complications.

Data sources: Clinical experience and scientific papers.

Conclusions: Reversal of facial aging via filler injection has been around since the late 1800s with the initial use of detrimental products. Today, many safe and effective products exist and can be tailored to the individual patient's desired effect. With the evolution of both products and injection techniques, the rate of complications with facial filler use is low. Nonetheless, providers offering facial filler injections should have detailed knowledge of facial anatomy, including facial planes and soft tissue compartments. Multiple injection techniques exist. Different techniques should be used, depending on the anatomic target. Providers should also know how to avoid and manage complications.

Objective: To provide an overview of the various treatment options available in the clinic to achieve periorbital rejuvenation.

Data sources: Literature review and expert opinion.

Conclusions: Periorbital rejuvenation in the clinic can be accomplished through a variety of treatment modalities, including topical therapies, skin resurfacing, and fillers and injectables. Furthermore, some surgical approaches, such as upper blepharoplasties, ptosis, and brow lifts, can be performed in the clinic under local anesthesia with only mild oral sedation. However, the successful execution of such procedures depends on proper patient selection and maximizing patient comfort.