Pub Date : 2024-12-01DOI: 10.1016/j.otot.2024.08.009
Bao Y. Sciscent BS, Neerav Goyal MD, MPH, FACS, Ciaran Lane MD
Neck dissection is a common procedure performed to remove lymph nodes in the neck that may contain cancer based on patterns of cervical metastases. Since the establishment of the radical neck dissection by Crile et al. in the early 20th century, modifications to this technique have been made. An understanding of lymphatic drainage patterns in the head and neck allowed for more limited dissections with reduced morbidity. This review discusses the history of neck dissection levels to its current accepted classification by the American Head and Neck Society, the evolving types of neck dissections, and different incisions used to optimize resection and cosmetic outcomes.
{"title":"Levels of the neck and classification of neck dissection and incisions","authors":"Bao Y. Sciscent BS, Neerav Goyal MD, MPH, FACS, Ciaran Lane MD","doi":"10.1016/j.otot.2024.08.009","DOIUrl":"10.1016/j.otot.2024.08.009","url":null,"abstract":"<div><div>Neck dissection is a common procedure performed to remove lymph nodes in the neck that may contain cancer based on patterns of cervical metastases. Since the establishment of the radical neck dissection by Crile et al. in the early 20th century, modifications to this technique have been made. An understanding of lymphatic drainage patterns in the head and neck allowed for more limited dissections with reduced morbidity. This review discusses the history of neck dissection levels to its current accepted classification by the American Head and Neck Society, the evolving types of neck dissections, and different incisions used to optimize resection and cosmetic outcomes.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 4","pages":"Pages 297-303"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173039","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 : 2024-12-01DOI: 10.1016/j.otot.2024.08.012
William Reed MD, MPH, Luigi Volpini MD, Andrew Fuson MD, Carissa M. Thomas MD, PhD
The posterolateral neck dissection removes the occipital and retroauricular lymph nodes in addition to nodal groups 2 through 5. This procedure is performed for the removal of metastatic or at-risk lymph nodes in the posterolateral neck, which most commonly originate from the cutaneous surfaces of the scalp and neck posterior to a coronal plane connecting the external auditory canals. The major surgical consideration is the identification and preservation of the spinal accessory nerve.
{"title":"The posterolateral neck dissection: indications, planning, and techniques","authors":"William Reed MD, MPH, Luigi Volpini MD, Andrew Fuson MD, Carissa M. Thomas MD, PhD","doi":"10.1016/j.otot.2024.08.012","DOIUrl":"10.1016/j.otot.2024.08.012","url":null,"abstract":"<div><div>The posterolateral neck dissection removes the occipital and retroauricular lymph nodes in addition to nodal groups 2 through 5. This procedure is performed for the removal of metastatic or at-risk lymph nodes in the posterolateral neck, which most commonly originate from the cutaneous surfaces of the scalp and neck posterior to a coronal plane connecting the external auditory canals. The major surgical consideration is the identification and preservation of the spinal accessory nerve.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 4","pages":"Pages 320-324"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173044","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 : 2024-09-01DOI: 10.1016/j.otot.2023.12.002
Shumon Ian Dhar MD, FACS, Anna Tomkies MD
Zenker's diverticulum is a pulsion-type pseudodiverticulum of the pharyngoesophageal segment. Endoscopic surgery is primarily directed at dividing the common wall between the esophagus and diverticulum. Rigid exposure with diverticuloscopes has allowed for common wall division with staplers, lasers, and advanced energy sealers, however, not all patients can be successfully treated with rigid instrumentation. As a result, flexible endoscopic surgery provides another option for patients. This technique employs various instrumentation through the working channel of a gastroscope to not only divide the common wall but seal the incision, which if done appropriately, results in a symptom resolution with complication rates comparable to rigid techniques. Flexible endoscopic surgery requires the surgeon to perform technically challenging submucosal dissection through a gastroscope as well as possess expertise with advanced energy delivery systems and instrumentation. However, with time, surgeons can build these skills to offer a breadth of surgical options tailored to the individual patient.
{"title":"Flexible Zenker's per-oral endoscopic myotomy","authors":"Shumon Ian Dhar MD, FACS, Anna Tomkies MD","doi":"10.1016/j.otot.2023.12.002","DOIUrl":"10.1016/j.otot.2023.12.002","url":null,"abstract":"<div><div><span>Zenker's diverticulum<span> is a pulsion-type pseudodiverticulum of the pharyngoesophageal segment. Endoscopic surgery<span> is primarily directed at dividing the common wall between the esophagus and diverticulum. Rigid exposure with diverticuloscopes has allowed for common wall division with staplers, lasers, and advanced energy sealers, however, not all patients can be successfully treated with rigid instrumentation. As a result, flexible endoscopic surgery provides another option for patients. This technique employs various instrumentation through the working channel of a gastroscope to not only divide the common wall but seal the </span></span></span>incision, which if done appropriately, results in a symptom resolution with complication rates comparable to rigid techniques. Flexible endoscopic surgery requires the surgeon to perform technically challenging submucosal dissection through a gastroscope as well as possess expertise with advanced energy delivery systems and instrumentation. However, with time, surgeons can build these skills to offer a breadth of surgical options tailored to the individual patient.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 213-219"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700769","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}
The dislocation of foreign bodies in the maxillary sinus is not an unusual complication of dental treatments like tooth extraction, root canal treatment, maxillary sinus surgery, or dental implant installation, whose related significant risk is the onset of pathologies involving the maxillary sinus or all the paranasal sinuses. Many previous techniques have been proposed, including intraoral and endoscopic approaches to sinus surgery. However, their recommendation varies depending on the local and systemic factors that affect patients.
This article describes the ``Bony Window Technique,'' which has been demonstrated as a mini-invasive approach to retrieve foreign bodies in the maxillary sinus to treat mild odontogenic sinusitis and systemic complications, even in different pathologic conditions of the maxillary sinus.
{"title":"The Bony Window Technique as a mini-invasive surgery to retrieve foreign bodies in the maxillary sinus: A technical note","authors":"Ettore Lupi MD, PhD , Giulia Ciciarelli DDS, PhD , Sara Bernardi DDS, PhD , Davide Gerardi DDS, PhD , Maurizio D'Amario DDS , Serena Bianchi MD, PhD , Filippo Giovannetti MD, PhD","doi":"10.1016/j.otot.2024.04.012","DOIUrl":"10.1016/j.otot.2024.04.012","url":null,"abstract":"<div><div>The dislocation of foreign bodies in the maxillary sinus is not an unusual complication of dental treatments like tooth extraction, root canal treatment, maxillary sinus surgery, or dental implant installation, whose related significant risk is the onset of pathologies involving the maxillary sinus or all the paranasal sinuses. Many previous techniques have been proposed, including intraoral and endoscopic approaches to sinus surgery. However, their recommendation varies depending on the local and systemic factors that affect patients.</div><div>This article describes the ``Bony Window Technique,'' which has been demonstrated as a mini-invasive approach to retrieve foreign bodies in the maxillary sinus to treat mild odontogenic sinusitis and systemic complications, even in different pathologic conditions of the maxillary sinus.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 242-248"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.otot.2024.02.002
Sapideh Gilani MD, FACS , William Ragan MD
To determine the best architectural plan for the extracranial and otolaryngology operating room, we queried PubMed and the Avery Index to Architectural Periodicals, Art Full Text, and Art Index Retrospective. for the key words "architecture," "operating room," and "otolaryngology." No relevant articles were found between 1989 and 2023. We created schematic diagrams of operating rooms in which we have operated over our combined careers and present the safest and most efficient configuration of the extracranial and otolaryngology surgery operating room. The architecture and medical literature have no recommendations for design and architectural details relevant to the extracranial operating room. Our specialty may wish to be proactive about this area of importance to our specialty. The medical, art, architecture literature offers no guidance for the optimal design and architectural layout of the extracranial operating room. Details to consider in such planning include patient and staff safety, anticipated patient and staff movement, OR efficiency, equipment size, placement and movement, line, and cord placement, and finally supply access. The authors suggest a configuration for the design and architectural layout for the extracranial surgery operating room.
为了确定颅外和耳鼻喉科手术室的最佳建筑方案，我们以 "建筑"、"手术室 "和 "耳鼻喉科 "为关键词，检索了 PubMed 和 Avery Index to Architectural Periodicals、Art Full Text 和 Art Index Retrospective。没有发现 1989 年至 2023 年期间的相关文章。我们绘制了我们职业生涯中手术室的示意图，并提出了颅外和耳鼻喉科手术室最安全、最有效的配置。建筑和医学文献中没有与颅外手术室相关的设计和建筑细节建议。我们的专业不妨在这一对本专业至关重要的领域采取积极主动的态度。医学、艺术和建筑文献没有为颅外手术室的最佳设计和建筑布局提供指导。此类规划需要考虑的细节包括患者和医护人员的安全、预期患者和医护人员的移动、手术室的效率、设备的大小、放置和移动、管路和脐带的放置，以及最后的供应通道。作者对颅外手术手术室的设计和建筑布局提出了建议。
{"title":"Operating room architecture in otolaryngology and extracranial surgery: A review","authors":"Sapideh Gilani MD, FACS , William Ragan MD","doi":"10.1016/j.otot.2024.02.002","DOIUrl":"10.1016/j.otot.2024.02.002","url":null,"abstract":"<div><div>To determine the best architectural plan for the extracranial and otolaryngology operating room, we queried PubMed and the Avery Index to Architectural Periodicals, Art Full Text, and Art Index Retrospective. for the key words \"architecture,\" \"operating room,\" and \"otolaryngology.\" No relevant articles were found between 1989 and 2023. We created schematic diagrams of operating rooms in which we have operated over our combined careers and present the safest and most efficient configuration of the extracranial and otolaryngology surgery operating room. The architecture and medical literature have no recommendations for design and architectural details relevant to the extracranial operating room. Our specialty may wish to be proactive about this area of importance to our specialty. The medical, art, architecture literature offers no guidance for the optimal design and architectural layout of the extracranial operating room. Details to consider in such planning include patient and staff safety, anticipated patient and staff movement, OR efficiency, equipment size, placement and movement, line, and cord placement, and finally supply access. The authors suggest a configuration for the design and architectural layout for the extracranial surgery operating room.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 237-241"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.otot.2024.05.001
Clare Quigley , Alkis Psaltis , Geoffrey E. Rose , Dinesh Selva
Excision of orbital cavernous venous malformations (OCVMs, “cavernous haemangiomas”), as with all orbital surgery, carries a risk of visual loss, and clinico-radiological features may provide an estimate of this risk. Awareness of this risk is necessary for clinical decision-making when planning surgery, radiotherapy or observation, and facilitates an informed consent. Endoscopic endonasal approaches for excision of OCVMs are increasingly performed, but visual outcomes are under-reported. We outline some important considerations in assessing the risk of visual loss after excision of OCVMs, with particular regard to endoscopic endonasal approaches.
{"title":"Risk factors for visual loss after excision of apical orbital cavernous venous malformations","authors":"Clare Quigley , Alkis Psaltis , Geoffrey E. Rose , Dinesh Selva","doi":"10.1016/j.otot.2024.05.001","DOIUrl":"10.1016/j.otot.2024.05.001","url":null,"abstract":"<div><div>Excision of orbital cavernous venous malformations (OCVMs, “cavernous haemangiomas”), as with all orbital surgery, carries a risk of visual loss, and clinico-radiological features may provide an estimate of this risk. Awareness of this risk is necessary for clinical decision-making when planning surgery, radiotherapy or observation, and facilitates an informed consent. Endoscopic endonasal approaches for excision of OCVMs are increasingly performed, but visual outcomes are under-reported. We outline some important considerations in assessing the risk of visual loss after excision of OCVMs, with particular regard to endoscopic endonasal approaches.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 249-252"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.otot.2024.08.020
David Goldenberg MD, FACS
{"title":"Operative technique in otolaryngology: A milestone issue","authors":"David Goldenberg MD, FACS","doi":"10.1016/j.otot.2024.08.020","DOIUrl":"10.1016/j.otot.2024.08.020","url":null,"abstract":"","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 205-206"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699808","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}
The variant type of preauricular sinus often presents with recurrent postauricular abscess, and history of repeated operations or incision and drainage. A dual incision technique is generally utilized with one incision being made in the preauricular and the other in the postauricular area. We report 4 cases of a variant type of preauricular sinus with recurrent postauricular abscesses. All cases were managed with single incision preauricular approach under operating microscope. Dual incision may be required if there is a persistent skin defect or fistulous communication at postaural area. The single incision is a less invasive acceptable technique for excision of variant type of preauricular sinus.
{"title":"The Variant type of Preauricular Sinus with Recurrent Postauricular Abscess: Excision by Single Incision Preauricular Approach","authors":"Kanu Lal Saha , Ripon Kumar Sarkar , S.M. Rasel Parvez","doi":"10.1016/j.otot.2024.01.016","DOIUrl":"10.1016/j.otot.2024.01.016","url":null,"abstract":"<div><div>The variant type of preauricular sinus often presents with recurrent postauricular abscess, and history of repeated operations or incision and drainage. A dual incision technique is generally utilized with one incision being made in the preauricular and the other in the postauricular area. We report 4 cases of a variant type of preauricular sinus with recurrent postauricular abscesses. All cases were managed with single incision preauricular approach under operating microscope. Dual incision may be required if there is a persistent skin defect or fistulous communication at postaural area. The single incision is a less invasive acceptable technique for excision of variant type of preauricular sinus.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 227-230"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636337","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 : 2024-09-01DOI: 10.1016/j.otot.2024.06.001
A.D. Rajgor MBChB , F.W. Stafford FRCS , A.K. Green MBBS , J. Ash MBBS , C.W. Lee MBBS
A total laryngectomy is used to resect laryngeal or hypopharyngeal cancer. Limited research exists on how incision location influences clinical outcomes. This study compares outcomes between 2 incision types; vertical midline (VMI) and apron-type incisions and determines whether this approach should be considered more frequently for primary total laryngectomy procedures. A retrospective analysis was undertaken at 2 tertiary specialist centres. The effect of skin incision technique on postoperative outcomes was analysed using regression modelling. Of the 79 patients included, 54 underwent an apron incision and 25 underwent a VMI. VMIs were significantly associated with reduced risk of lymphoedema (P = 0.011) and pharyngocutaneous fistula (PCF) (P = 0.031). Regression analysis demonstrated incision technique did not influence recurrence (HR2.28; 95% CI 0.61-8.53; P = 0.219) or survival (HR1.41; 95% CI 0.55-3.65; P = 0.477). However, apron incisions increased the odds of minor (OR9.59; 95% CI 1.34-68.82; P = 0.025) and major (OR3.59; 95% CI 1.71-78.21; P = 0.045) complications. VMI is a safe and effective approach for performing laryngectomies and does not have inferior outcomes with regard to complications, recurrence rate or survival. Additional morbidity from the routine use of flap reconstruction in salvage surgery can be avoided. A vertical approach should be considered for laryngectomy resections even in the presence of encapsulated lateral nodal disease.
全喉切除术用于切除喉癌或下咽癌。关于切口位置如何影响临床效果的研究十分有限。本研究比较了两种切口类型（垂直中线（VMI）切口和围裙式切口）的疗效，并确定是否应在初级全喉切除术中更多地考虑这种方法。两家三级专科中心进行了一项回顾性分析。采用回归模型分析了皮肤切口技术对术后效果的影响。在纳入的 79 位患者中，54 位接受了围裙切口，25 位接受了 VMI 切口。VMI 与淋巴水肿（P = 0.011）和咽瘘（PCF）（P = 0.031）风险的降低有明显相关性。回归分析表明，切口技术不会影响复发率（HR2.28；95% CI 0.61-8.53；P = 0.219）或存活率（HR1.41；95% CI 0.55-3.65；P = 0.477）。然而，围裙切口会增加轻微（OR9.59；95% CI 1.34-68.82；P = 0.025）和严重（OR3.59；95% CI 1.71-78.21；P = 0.045）并发症的几率。VMI是进行喉切除术的一种安全有效的方法，在并发症、复发率或存活率方面没有劣势。在抢救手术中常规使用皮瓣重建可避免额外的发病率。即使存在包裹性侧结节疾病，也应考虑采用垂直方法进行喉切除术。
{"title":"The vertical midline incision is a safe and effective technique for primary total laryngectomy procedures","authors":"A.D. Rajgor MBChB , F.W. Stafford FRCS , A.K. Green MBBS , J. Ash MBBS , C.W. Lee MBBS","doi":"10.1016/j.otot.2024.06.001","DOIUrl":"10.1016/j.otot.2024.06.001","url":null,"abstract":"<div><div>A total laryngectomy is used to resect laryngeal or hypopharyngeal cancer. Limited research exists on how incision location influences clinical outcomes. This study compares outcomes between 2 incision types; vertical midline (VMI) and apron-type incisions and determines whether this approach should be considered more frequently for primary total laryngectomy procedures. A retrospective analysis was undertaken at 2 tertiary specialist centres. The effect of skin incision technique on postoperative outcomes was analysed using regression modelling. Of the 79 patients included, 54 underwent an apron incision and 25 underwent a VMI. VMIs were significantly associated with reduced risk of lymphoedema (<em>P = 0.011</em>) and pharyngocutaneous fistula (PCF) (<em>P = 0.031</em>). Regression analysis demonstrated incision technique did not influence recurrence (HR2.28; 95% CI 0.61-8.53; <em>P =</em> 0.219) or survival (HR1.41; 95% CI 0.55-3.65; <em>P =</em> 0.477). However, apron incisions increased the odds of minor (OR9.59; 95% CI 1.34-68.82; <em>P =</em> 0.025) and major (OR3.59; 95% CI 1.71-78.21; <em>P =</em> 0.045) complications. VMI is a safe and effective approach for performing laryngectomies and does not have inferior outcomes with regard to complications, recurrence rate or survival. Additional morbidity from the routine use of flap reconstruction in salvage surgery can be avoided. A vertical approach should be considered for laryngectomy resections even in the presence of encapsulated lateral nodal disease.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 253-263"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714233","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 : 2024-09-01DOI: 10.1016/j.otot.2024.08.002
Prashanth Lowell Monis MDS, Athiramol CK MDS, Samarth Shetty MDS, MFDS RCS (Eng.), FFDRCS (Ire.), Paul Christadas Salins MDS, FDS RCS (Eng.), FFDRCS (Ire.), PG Dip. Med
Glossopharyngeal neuralgia (GPN) is a rare, debilitating neurologic condition characterized by intermittent pain radiating to the tongue, pharynx or ear that can be triggered by talking, swallowing or chewing. With an incidence of only 0.2-0.7 persons/100,000/year, the diagnosis is extremely challenging and often gets misdiagnosed and undiagnosed. Many treatment options have been tried by various clinicians in the past, such as medical therapy (antidepressants, opiods, antiepileptics, steroids, and membrane-stabilizing agents), nerve blocks with or without additives, gamma knife radiosurgery, radiofrequency ablation and microvascular decompression. Each of the aforementioned treatment modalities has its own merits and limitations. In the pursuit of delivering optimal treatment for pain relief in GPN and to improve patient's quality of life, we have explored the use of Botulinum toxin type A (BOTOX [Allegran]). BOTOX has been widely used in the treatment of chronic facial pain such as headaches, migraine, and trigeminal neuralgia. However, the use of BOTOX in the management of GPN has not been reported in the literature. Despite the small number of cases in our series, BOTOX therapy in GPN appears to be promising. However, further research with larger sample sizes and longer follow-up periods is needed to fully establish its efficacy and safety profile
{"title":"Botulinum toxin type a (BOTOX) in the management of glossopharyngeal neuralgia- A case series","authors":"Prashanth Lowell Monis MDS, Athiramol CK MDS, Samarth Shetty MDS, MFDS RCS (Eng.), FFDRCS (Ire.), Paul Christadas Salins MDS, FDS RCS (Eng.), FFDRCS (Ire.), PG Dip. Med","doi":"10.1016/j.otot.2024.08.002","DOIUrl":"10.1016/j.otot.2024.08.002","url":null,"abstract":"<div><div>Glossopharyngeal neuralgia (GPN) is a rare, debilitating neurologic condition characterized by intermittent pain radiating to the tongue, pharynx or ear that can be triggered by talking, swallowing or chewing. With an incidence of only 0.2-0.7 persons/100,000/year, the diagnosis is extremely challenging and often gets misdiagnosed and undiagnosed. Many treatment options have been tried by various clinicians in the past, such as medical therapy (antidepressants, opiods, antiepileptics, steroids, and membrane-stabilizing agents), nerve blocks with or without additives, gamma knife radiosurgery, radiofrequency ablation and microvascular decompression. Each of the aforementioned treatment modalities has its own merits and limitations. In the pursuit of delivering optimal treatment for pain relief in GPN and to improve patient's quality of life, we have explored the use of Botulinum toxin type A (BOTOX [Allegran]). BOTOX has been widely used in the treatment of chronic facial pain such as headaches, migraine, and trigeminal neuralgia. However, the use of BOTOX in the management of GPN has not been reported in the literature. Despite the small number of cases in our series, BOTOX therapy in GPN appears to be promising. However, further research with larger sample sizes and longer follow-up periods is needed to fully establish its efficacy and safety profile</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"35 3","pages":"Pages 281-287"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699806","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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