Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.004
Pablo Antonio Ysunza MD, PhD, CCC-SLP, CNIM
Velopharyngeal insufficiency (VPI) must be corrected by a surgical procedure or a prosthetic appliance. Both options must be customized according to imaging findings as provided by videonasopharyngoscopy (VNP) and multiplanar videofluoroscopy (MPVF). The purpose of this chapter is to describe the appropriate performance of VNP and MPVF for planning the surgical procedure for correcting VPI. VNP and MPVF provide the necessary information for planning the surgical treatment of VPI with the highest probability of success.
{"title":"Imaging in velopharyngeal insufficiency assessment","authors":"Pablo Antonio Ysunza MD, PhD, CCC-SLP, CNIM","doi":"10.1016/j.otot.2025.10.004","DOIUrl":"10.1016/j.otot.2025.10.004","url":null,"abstract":"<div><div>Velopharyngeal insufficiency (VPI) must be corrected by a surgical procedure or a prosthetic appliance. Both options must be customized according to imaging findings as provided by videonasopharyngoscopy (VNP) and multiplanar videofluoroscopy (MPVF). The purpose of this chapter is to describe the appropriate performance of VNP and MPVF for planning the surgical procedure for correcting VPI. VNP and MPVF provide the necessary information for planning the surgical treatment of VPI with the highest probability of success.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 258-261"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719018","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}
Velopharyngeal insufficiency (VPI) is a condition characterized by incomplete closure of the velopharyngeal sphincter, leading to hypernasality, nasal air escape, and speech intelligibility issues. The Furlow double opposing Z-plasty technique has emerged as an effective surgical approach for treating VPI by improving velopharyngeal closure through soft tissue reconfiguration. This technique can be performed with various palate widths and heights, in addition to different cleft types. Surgical indications, procedural steps, postoperative outcomes, and complications are discussed.
{"title":"Furlow double opposing Z-Plasty for treatment of VPI","authors":"Omri Emodi MD, DMD , Tal Capucha DMD, PhD , Michal Even-Almos MD, DMD , Andrie Krasovsky DMD , Chaim Ohayon DMD , Amir Bilder DMD, MSc , Nidal Zeineh DMD, PhD","doi":"10.1016/j.otot.2025.10.007","DOIUrl":"10.1016/j.otot.2025.10.007","url":null,"abstract":"<div><div>Velopharyngeal insufficiency (VPI) is a condition characterized by incomplete closure of the velopharyngeal sphincter, leading to hypernasality, nasal air escape, and speech intelligibility issues. The Furlow double opposing Z-plasty technique has emerged as an effective surgical approach for treating VPI by improving velopharyngeal closure through soft tissue reconfiguration. This technique can be performed with various palate widths and heights, in addition to different cleft types. Surgical indications, procedural steps, postoperative outcomes, and complications are discussed.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 268-272"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719020","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.05.003
Sarah C. Nyirjesy , Emilie C.M. de Groot , Jeremy D. Richmon , Allen L. Feng
Purpose
The facial artery myomucosal (FAMM) flap is an interpolated intraoral flap that is typically done in a staged fashion when reconstructing the oral tongue for dentate patients. However, the tunneled FAMM (t-FAMM) is a modification that provides a single stage reconstructive option. This study demonstrates the utility of the t-FAMM flap in reconstructing oral tongue defects in early-stage oral cavity squamous cell carcinoma (OCSCC), obviating the need for free tissue transfer while allowing for early initiation of swallow.
Methods
From 2023 – 2024, five patients with early-stage OSCC with FAMM flap reconstruction were reviewed. Basic patient demographics along were collected along with swallowing initiation and outcomes using the MD Anderson Dysphagia Inventory (MDADI) score.
Results
Five consecutive patients underwent t-FAMM flap reconstruction for early-stage OCSCC. The average tumor size was 1.5 cm (range, 0.8 – 2.5cm). The average operative time was 258 minutes (range, 213 – 296 minutes). t-FAMM flap size varied between 5 × 2cm (10cm2) and 7 × 3cm (21cm2) and the median length of stay was 3 days (range, 3 – 4 days). All donor sites were closed primarily. On average, patients restarted swallowing 2.3 days (range, 1 – 4 days) post-operatively and by 3 months post-operatively, patients had an average MDADI score of 96 (range, 92 – 100).
Conclusion
The t-FAMM flap is an excellent reconstructive option for early-stage OCSCC for small to medium sized defects. It provides a single stage reconstructive option in dentulous patients, reduces operative times when compared to free flap reconstruction, and enables early swallowing initiation while providing excellent swallowing outcomes.
{"title":"Tunneled facial artery myomucosal (t-FAMM) flap reconstruction for early stage oral tongue squamous cell carcinoma: Shorter operative times and earlier swallowing","authors":"Sarah C. Nyirjesy , Emilie C.M. de Groot , Jeremy D. Richmon , Allen L. Feng","doi":"10.1016/j.otot.2025.05.003","DOIUrl":"10.1016/j.otot.2025.05.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The facial artery myomucosal (FAMM) flap is an interpolated intraoral flap that is typically done in a staged fashion when reconstructing the oral tongue for dentate patients. However, the tunneled FAMM (t-FAMM) is a modification that provides a single stage reconstructive option. This study demonstrates the utility of the t-FAMM flap in reconstructing oral tongue defects in early-stage oral cavity squamous cell carcinoma (OCSCC), obviating the need for free tissue transfer while allowing for early initiation of swallow.</div></div><div><h3>Methods</h3><div>From 2023 – 2024, five patients with early-stage OSCC with FAMM flap reconstruction were reviewed. Basic patient demographics along were collected along with swallowing initiation and outcomes using the MD Anderson Dysphagia Inventory (MDADI) score.</div></div><div><h3>Results</h3><div>Five consecutive patients underwent t-FAMM flap reconstruction for early-stage OCSCC. The average tumor size was 1.5 cm (range, 0.8 – 2.5cm). The average operative time was 258 minutes (range, 213 – 296 minutes). t-FAMM flap size varied between 5 × 2cm (10cm<sup>2</sup>) and 7 × 3cm (21cm<sup>2</sup>) and the median length of stay was 3 days (range, 3 – 4 days). All donor sites were closed primarily. On average, patients restarted swallowing 2.3 days (range, 1 – 4 days) post-operatively and by 3 months post-operatively, patients had an average MDADI score of 96 (range, 92 – 100).</div></div><div><h3>Conclusion</h3><div>The t-FAMM flap is an excellent reconstructive option for early-stage OCSCC for small to medium sized defects. It provides a single stage reconstructive option in dentulous patients, reduces operative times when compared to free flap reconstruction, and enables early swallowing initiation while providing excellent swallowing outcomes.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 326-332"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753671","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2024.10.001
Philipp Verpukhovskiy BS , Ronik Kothari BA , Sapideh Gilani MD
To determine best practices for a live electrical wire in the operating room and prevention of injuries from such an emergency. We queried PubMed, Embase and Cochrane Review for key words “electrical” “wire” “operating room” and “fire.” No relevant articles were found between 1989 and 2024. We present a case of a live 110-volt wire in the operating room from tripping on the cord. We review recommendations for safe response to such a scenario. No relevant articles were found. Medical literature has many articles on fires, but none on live electrical wires and safe response to such a scenario. A live electrical power cord wire is a dangerous occurrence in the operating room and may result in electrocution, burns or a fire and resultant injuries. The authors recommend immediate turning off of oxygen, isolating the patient, personnel, liquids and flammable drapes as well as immediate notation of the outlet number and turning off of the electricity from the electrical panel. Electrical fires cannot be doused with water or foam and must be eliminated with a class C fire extinguisher, typically carbon monoxide.
{"title":"Live electrical wire in the operating room: a review of the literature","authors":"Philipp Verpukhovskiy BS , Ronik Kothari BA , Sapideh Gilani MD","doi":"10.1016/j.otot.2024.10.001","DOIUrl":"10.1016/j.otot.2024.10.001","url":null,"abstract":"<div><div>To determine best practices for a live electrical wire in the operating room and prevention of injuries from such an emergency. We queried PubMed, Embase and Cochrane Review for key words “electrical” “wire” “operating room” and “fire.” No relevant articles were found between 1989 and 2024. We present a case of a live 110-volt wire in the operating room from tripping on the cord. We review recommendations for safe response to such a scenario. No relevant articles were found. Medical literature has many articles on fires, but none on live electrical wires and safe response to such a scenario. A live electrical power cord wire is a dangerous occurrence in the operating room and may result in electrocution, burns or a fire and resultant injuries. The authors recommend immediate turning off of oxygen, isolating the patient, personnel, liquids and flammable drapes as well as immediate notation of the outlet number and turning off of the electricity from the electrical panel. Electrical fires cannot be doused with water or foam and must be eliminated with a class C fire extinguisher, typically carbon monoxide.</div><div>Level of Evidence: 1</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 348-352"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753675","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2024.09.001
Christopher D. Pool MD, Jessyka G. Lighthall MD, FACS
{"title":"Corrigendum to “The modified mini direct bone-anchored browlift for frontal paralysis” [Operative Techniques in Otolaryngology-Head and Neck Surgery 2023; 34: e20–e22]","authors":"Christopher D. Pool MD, Jessyka G. Lighthall MD, FACS","doi":"10.1016/j.otot.2024.09.001","DOIUrl":"10.1016/j.otot.2024.09.001","url":null,"abstract":"","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Page 372"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753639","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.005
Matan Katz MD, Yaniv Ebner MD, BPharm
Cleft palate repair is a cornerstone procedure in the management of children with cleft palate, with a significant impact on feeding, speech, hearing, and craniofacial development. This chapter outlines a progressive, anatomy-based surgical strategy for cleft palate repair, emphasizing individualized decision-making based on intraoperative findings. Beginning with intervelar veloplasty and escalating only when needed to lateral relaxing incisions, vomer flap use, or posterior pushback techniques, the approach prioritizes the restoration of the levator veli palatini sling, tension-free closure, and minimal scarring of the hard palate. Key technical steps, including meticulous muscle dissection and layered closure of nasal and oral mucosa, are described in detail. Special consideration should be given to airway implications in pediatric patients, as well as the role of the otolaryngologist in managing concurrent Eustachian tube dysfunction. An additional option, the Furlow double-opposing Z-plasty, is briefly presented as an alternative technique for select cases. This chapter integrates embryological understanding, surgical technique, and long-term functional goals to optimize velopharyngeal competence and reduce complications such as fistulae or velopharyngeal insufficiency (VPI). Cleft lip is beyond the scope of this chapter and does not result in VPI.
{"title":"Cleft palate repair for velopharyngeal insufficiency","authors":"Matan Katz MD, Yaniv Ebner MD, BPharm","doi":"10.1016/j.otot.2025.10.005","DOIUrl":"10.1016/j.otot.2025.10.005","url":null,"abstract":"<div><div>Cleft palate repair is a cornerstone procedure in the management of children with cleft palate, with a significant impact on feeding, speech, hearing, and craniofacial development. This chapter outlines a progressive, anatomy-based surgical strategy for cleft palate repair, emphasizing individualized decision-making based on intraoperative findings. Beginning with intervelar veloplasty and escalating only when needed to lateral relaxing incisions, vomer flap use, or posterior pushback techniques, the approach prioritizes the restoration of the levator veli palatini sling, tension-free closure, and minimal scarring of the hard palate. Key technical steps, including meticulous muscle dissection and layered closure of nasal and oral mucosa, are described in detail. Special consideration should be given to airway implications in pediatric patients, as well as the role of the otolaryngologist in managing concurrent Eustachian tube dysfunction. An additional option, the Furlow double-opposing Z-plasty, is briefly presented as an alternative technique for select cases. This chapter integrates embryological understanding, surgical technique, and long-term functional goals to optimize velopharyngeal competence and reduce complications such as fistulae or velopharyngeal insufficiency (VPI). Cleft lip is beyond the scope of this chapter and does not result in VPI.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 262-267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719019","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.012
Gil Zoizner-Agar MD
Middle ear pathology, most commonly otitis media with effusion accompanied by hearing loss, is almost universal in patients with cleft palate. This poses further challenges to an already complex patient population. Ventilation tube insertion provides an immediate solution, in theory, to middle ear effusion and pressure equalization. In practice, optimal management of the middle ear in patients with a cleft palate is still controversial, with inconclusive evidence to guide when, and even if, to place ventilation tubes. A review of current evidence will be presented regarding pathophysiology and incidence of middle ear disease in this population, as well as considerations to guide management.
{"title":"Management of the middle ear in patients with cleft palate","authors":"Gil Zoizner-Agar MD","doi":"10.1016/j.otot.2025.10.012","DOIUrl":"10.1016/j.otot.2025.10.012","url":null,"abstract":"<div><div>Middle ear pathology, most commonly otitis media with effusion accompanied by hearing loss, is almost universal in patients with cleft palate. This poses further challenges to an already complex patient population. Ventilation tube insertion provides an immediate solution, in theory, to middle ear effusion and pressure equalization. In practice, optimal management of the middle ear in patients with a cleft palate is still controversial, with inconclusive evidence to guide when, and even if, to place ventilation tubes. A review of current evidence will be presented regarding pathophysiology and incidence of middle ear disease in this population, as well as considerations to guide management.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 290-294"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719026","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.09.016
Mohammad Faramarzi MD , Ali Faramarzi MD
Scutum removal is essential in stapes surgery to expose the stapes footplate and oval window. We introduce a custom osteotome and retrospectively compared five scutum-removal techniques across 113 stapes surgeries (curette, drill, osteotome, osteotome + curette, osteotome + drill). Osteotome-based methods achieved a significantly shorter scutum-removal time (P < 0.001), without differences in postoperative air–bone gap closure and with no cases of facial nerve injury, incus–stapes trauma, or sensorineural hearing loss complications (all P > 0.05). The osteotome is reusable and lower-cost than drilling. These data support the osteotome as an efficient, safe, and economical option for microscopic stapes surgery, warranting prospective validation.
{"title":"Ear osteotome for scutum removal in stapes surgery","authors":"Mohammad Faramarzi MD , Ali Faramarzi MD","doi":"10.1016/j.otot.2025.09.016","DOIUrl":"10.1016/j.otot.2025.09.016","url":null,"abstract":"<div><div>Scutum removal is essential in stapes surgery to expose the stapes footplate and oval window. We introduce a custom osteotome and retrospectively compared five scutum-removal techniques across 113 stapes surgeries (curette, drill, osteotome, osteotome + curette, osteotome + drill). Osteotome-based methods achieved a significantly shorter scutum-removal time (<em>P</em> < 0.001), without differences in postoperative air–bone gap closure and with no cases of facial nerve injury, incus–stapes trauma, or sensorineural hearing loss complications (all <em>P</em> > 0.05). The osteotome is reusable and lower-cost than drilling. These data support the osteotome as an efficient, safe, and economical option for microscopic stapes surgery, warranting prospective validation.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 343-347"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753674","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}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.01.006
Aarti Agarwal MD , Ramez Philips MD , Sruti Tekumalla MD , Gurston G. Nyquist MD , James J. Evans MD , Jurij R. Bilyk MD , Larissa Sweeny MD , Mark Wax MD , Joseph M. Curry MD
Reconstruction of anterior skull base defects relies on upholding important principles including, obtaining watertight dural seal, supporting neural structures, reconstructing anatomic and nonanatomic structures, covering exposed vessels, maintaining function and optimizing aesthetics. Current advances in skull base reconstruction include minimally invasive approaches to reconstruction using a combination of endoscopic and open access which can mitigate the need for larger ablative and reconstructive procedures. However, many advanced or recurrent tumors may require open procedures with complex reconstruction. Well-planned soft tissue or composite free tissue transfer can optimize the likelihood of safely achieving skull base reconstructive principles. Pedicle management is paramount due to complex anatomy, distance to donor vessels, and, frequently, prior surgical intervention. Technological advances such as virtual planning offer the potential to reduce and overcome multiple challenges for the reconstructive surgeon. Technological advances such as virtual surgical planning (VSP) have been shown to decrease operative time and may also provide opportunities to improve outcomes and overcome technical limitations. Other advances including current clinical research in neoadjuvant chemotherapeutic and immunotherapeutic strategies will impact the future of skullbase surgery and reconstruction.
{"title":"Technical considerations for cranial base reconstruction","authors":"Aarti Agarwal MD , Ramez Philips MD , Sruti Tekumalla MD , Gurston G. Nyquist MD , James J. Evans MD , Jurij R. Bilyk MD , Larissa Sweeny MD , Mark Wax MD , Joseph M. Curry MD","doi":"10.1016/j.otot.2025.01.006","DOIUrl":"10.1016/j.otot.2025.01.006","url":null,"abstract":"<div><div>Reconstruction of anterior skull base defects relies on upholding important principles including, obtaining watertight dural seal, supporting neural structures, reconstructing anatomic and nonanatomic structures, covering exposed vessels, maintaining function and optimizing aesthetics. Current advances in skull base reconstruction include minimally invasive approaches to reconstruction using a combination of endoscopic and open access which can mitigate the need for larger ablative and reconstructive procedures. However, many advanced or recurrent tumors may require open procedures with complex reconstruction. Well-planned soft tissue or composite free tissue transfer can optimize the likelihood of safely achieving skull base reconstructive principles. Pedicle management is paramount due to complex anatomy, distance to donor vessels, and, frequently, prior surgical intervention. Technological advances such as virtual planning offer the potential to reduce and overcome multiple challenges for the reconstructive surgeon. Technological advances such as virtual surgical planning (VSP) have been shown to decrease operative time and may also provide opportunities to improve outcomes and overcome technical limitations. Other advances including current clinical research in neoadjuvant chemotherapeutic and immunotherapeutic strategies will impact the future of skullbase surgery and reconstruction.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 353-364"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753676","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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