Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.05.002
Robert Calvisi MBBS, FRACS , Calandra Li MD, MSc , Marc Levin MD, FRCSC , Antoine Eskander MD, MSc, FRCSC , Danny Enepekides MD, MPH, FRCSC , Kevin Higgins MD, MSc, FRCSC
Reanimation of the paralyzed face remains a challenging area for the reconstructive surgeon, with several static and dynamic surgical options. This study aimed to describe a novel technique for lower lip depressor re-animation using nerve to mylohyoid (MHN) to marginal mandibular nerve (MMN) transfer. Four patients underwent MHN-MMN transfer following facial nerve sacrifice following oncological resection of salivary gland malignancy or MMN sacrifice during neck dissection for oral cavity malignancy. All 4 patients recovered from their surgeries without perioperative complications. Re-innervation is not yet seen given the short duration of follow-up time. The anatomical feasibility of transferring the MHN to the MMN for re-innervation of the lower lip depressors is a feasible surgical reanimation technique with anatomical compatibility and minimal donor-site morbidity. The MHN to MMN nerve transfer is a technically feasible lower lip depressor reanimation technique with theoretical advantages over currently accepted treatment options. Increased patient numbers and longer follow-up intervals are required to study the clinical effectiveness.
{"title":"A Novel Technique for Lower Lip Depressor Re-Animation Using the Nerve to Myloyhoid to Marginal Mandibular Nerve Transfer","authors":"Robert Calvisi MBBS, FRACS , Calandra Li MD, MSc , Marc Levin MD, FRCSC , Antoine Eskander MD, MSc, FRCSC , Danny Enepekides MD, MPH, FRCSC , Kevin Higgins MD, MSc, FRCSC","doi":"10.1016/j.otot.2025.05.002","DOIUrl":"10.1016/j.otot.2025.05.002","url":null,"abstract":"<div><div>Reanimation of the paralyzed face remains a challenging area for the reconstructive surgeon, with several static and dynamic surgical options. This study aimed to describe a novel technique for lower lip depressor re-animation using nerve to mylohyoid (MHN) to marginal mandibular nerve (MMN) transfer. Four patients underwent MHN-MMN transfer following facial nerve sacrifice following oncological resection of salivary gland malignancy or MMN sacrifice during neck dissection for oral cavity malignancy. All 4 patients recovered from their surgeries without perioperative complications. Re-innervation is not yet seen given the short duration of follow-up time. The anatomical feasibility of transferring the MHN to the MMN for re-innervation of the lower lip depressors is a feasible surgical reanimation technique with anatomical compatibility and minimal donor-site morbidity. The MHN to MMN nerve transfer is a technically feasible lower lip depressor reanimation technique with theoretical advantages over currently accepted treatment options. Increased patient numbers and longer follow-up intervals are required to study the clinical effectiveness.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 319-325"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753670","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.2025.06.001
Sukhpreet Singh Dubb , Sarika Shivji , Andrew Camilleri
Hirudotherapy employs the use of medicinal leeches to salvage failing flaps typically from venous congestions. They can be an invaluable resource in the head and neck armamentarium. There is a paucity of published literature on the technical aspects of hirudotherapy to optimize their use including sourcing, handling, placement and removal. We present an overview of these alongside a novel technique to simultaneously review leeches and flaps ensuring ease of use.
{"title":"Technical pearls in hirudotherapy for venous congested flaps","authors":"Sukhpreet Singh Dubb , Sarika Shivji , Andrew Camilleri","doi":"10.1016/j.otot.2025.06.001","DOIUrl":"10.1016/j.otot.2025.06.001","url":null,"abstract":"<div><div><span>Hirudotherapy employs the use of medicinal leeches to salvage failing flaps typically from </span>venous congestions. They can be an invaluable resource in the head and neck armamentarium. There is a paucity of published literature on the technical aspects of hirudotherapy to optimize their use including sourcing, handling, placement and removal. We present an overview of these alongside a novel technique to simultaneously review leeches and flaps ensuring ease of use.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 333-335"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753672","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.2025.10.011
Tal Hefetz MD, Yaniv Ebner MD, BPharm
Children with 22q11.2 deletion syndrome frequently exhibit velopharyngeal insufficiency (VPI), often related to characteristic craniofacial anomalies including a shortened palate, submucous cleft palate and a wide velopharyngeal gap. Posterior pharyngeal flap (PPF) surgery is commonly employed for VPI correction in this population; however, up to 25%-49% of these patients may have medially displaced internal carotid arteries (ICA), significantly increasing surgical risk. Preoperative vascular imaging, particularly cervical magnetic resonance angiography (MRA), can identify ICA medialization and guide surgical modification in approximately 20% of cases. Mild ICA medialization may be addressed with standard neck extension to laterally displace the vessels intraoperatively, but more severe displacement may warrant a carotid mobilization technique, involving cervical incision and vessel retraction prior to flap inset. Furthermore, 22q11.2 deletion syndrome patients often present with neuromuscular hypotonia and reduced lateral pharyngeal wall movement, necessitating careful nasopharyngeal endoscopic assessment and potentially a wider flap or sphincter pharyngoplasty. Overall, individualized surgical planning, informed by anatomical and functional evaluation, is critical to safely and effectively manage VPI in this complex patient group.
{"title":"Special surgical considerations in pharyngplasty VPI surgeries for patients with 22q11.2 deletion syndrome","authors":"Tal Hefetz MD, Yaniv Ebner MD, BPharm","doi":"10.1016/j.otot.2025.10.011","DOIUrl":"10.1016/j.otot.2025.10.011","url":null,"abstract":"<div><div>Children with 22q11.2 deletion syndrome frequently exhibit velopharyngeal insufficiency (VPI), often related to characteristic craniofacial anomalies including a shortened palate, submucous cleft palate and a wide velopharyngeal gap. Posterior pharyngeal flap (PPF) surgery is commonly employed for VPI correction in this population; however, up to 25%-49% of these patients may have medially displaced internal carotid arteries (ICA), significantly increasing surgical risk. Preoperative vascular imaging, particularly cervical magnetic resonance angiography (MRA), can identify ICA medialization and guide surgical modification in approximately 20% of cases. Mild ICA medialization may be addressed with standard neck extension to laterally displace the vessels intraoperatively, but more severe displacement may warrant a carotid mobilization technique, involving cervical incision and vessel retraction prior to flap inset. Furthermore, 22q11.2 deletion syndrome patients often present with neuromuscular hypotonia and reduced lateral pharyngeal wall movement, necessitating careful nasopharyngeal endoscopic assessment and potentially a wider flap or sphincter pharyngoplasty. Overall, individualized surgical planning, informed by anatomical and functional evaluation, is critical to safely and effectively manage VPI in this complex patient group.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 288-289"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719025","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.2025.12.001
{"title":"Publisher...s Note","authors":"","doi":"10.1016/j.otot.2025.12.001","DOIUrl":"10.1016/j.otot.2025.12.001","url":null,"abstract":"","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Page 295"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719027","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.2025.10.010
Yaniv Ebner MD, BPharm, Yair Donin MD
Posterior pharyngeal wall augmentation is a surgical intervention for managing velopharyngeal insufficiency in patients with adequate palatal mobility but small persistent gaps. By increasing posterior pharyngeal wall bulk, the technique aims to narrow the sphincter and improve velopharyngeal closure and reduce nasal air escape. This method serves as either a primary procedure or an adjunct to address residual mild velopharyngeal insufficiency following prior palatoplasty or pharyngoplasty. Benefits include shorter operative time, reduced hospitalization, and faster recovery. Careful preoperative assessment is critical, including speech evaluation, nasopharyngoscopy, and measurement of the gap size. Autologous fat is a commonly chosen augmentation material due to its biocompatibility, though resorption rates remain high; synthetic alternatives are available but carry their own risks. Under general anesthesia, harvested and processed fat or alloplastic material is injected transorally into the posterior pharyngeal wall under endoscopic guidance. Overcorrection is often required to account for postoperative resorption, with the trade-off of short-term nasal obstruction or sleep-disordered breathing. Most patients are discharged the same day and begin speech therapy within a week. Follow-up includes nasopharyngoscopy at one and 3 months to assess results and determine the need for further interventions.
{"title":"Augmentation pharyngoplasty","authors":"Yaniv Ebner MD, BPharm, Yair Donin MD","doi":"10.1016/j.otot.2025.10.010","DOIUrl":"10.1016/j.otot.2025.10.010","url":null,"abstract":"<div><div>Posterior pharyngeal wall augmentation is a surgical intervention for managing velopharyngeal insufficiency in patients with adequate palatal mobility but small persistent gaps. By increasing posterior pharyngeal wall bulk, the technique aims to narrow the sphincter and improve velopharyngeal closure and reduce nasal air escape. This method serves as either a primary procedure or an adjunct to address residual mild velopharyngeal insufficiency following prior palatoplasty or pharyngoplasty. Benefits include shorter operative time, reduced hospitalization, and faster recovery. Careful preoperative assessment is critical, including speech evaluation, nasopharyngoscopy, and measurement of the gap size. Autologous fat is a commonly chosen augmentation material due to its biocompatibility, though resorption rates remain high; synthetic alternatives are available but carry their own risks. Under general anesthesia, harvested and processed fat or alloplastic material is injected transorally into the posterior pharyngeal wall under endoscopic guidance. Overcorrection is often required to account for postoperative resorption, with the trade-off of short-term nasal obstruction or sleep-disordered breathing. Most patients are discharged the same day and begin speech therapy within a week. Follow-up includes nasopharyngoscopy at one and 3 months to assess results and determine the need for further interventions.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 285-287"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719024","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.2025.09.014
Mohammed Taiyyib Arshad MBBS , Aneesa Arshad MBBS
Free flap surgery is the gold standard for complex oral and maxillofacial reconstruction. However, complications may necessitate secondary procedures, adversely impacting patient outcomes. This review examines how preoperative radiotherapy, previous head and neck surgery, and female sex influence complication rates in free flap procedures. It also examines the input of the surgical team, methods of reconstruction & anatomical location of the defect and how these affect the secondary surgery. A literature review was conducted using systematic reviews, clinical trials, retrospective studies, and laboratory research to evaluate the impact of these three risk factors on postoperative outcomes and how surgical teams manage adverse ones. Preoperative radiotherapy increases the risk of flap failure by 1.8 times, primarily due to fibrosis and compromised vascularity, particularly when surgery is delayed beyond six weeks post-radiotherapy. Female patients demonstrate a 1.58-fold higher complication risk, potentially due to hormonal fluctuations, anemia, and menstrual cycle-related changes. A history of head and neck surgery raises complication rates by 1.64 times, attributed to scar formation, altered anatomy, and impaired vascular supply. Timing surgery appropriately following radiotherapy and considering menstrual cycles in female patients, alongside cautious flap selection in previously operated regions, may reduce complications. The data underscores the need for standardized surgical protocols and more research into sex-specific physiological factors. Tailored perioperative planning based on patient-specific risk factors is essential to minimize complications, reduce flap failure rates, and improve functional and aesthetic outcomes in oral and maxillofacial free flap reconstruction.
{"title":"An exploration into the factors resulting in secondary free flap requirement in flap transfer in oral and maxillofacial surgery in the UK: Literature review","authors":"Mohammed Taiyyib Arshad MBBS , Aneesa Arshad MBBS","doi":"10.1016/j.otot.2025.09.014","DOIUrl":"10.1016/j.otot.2025.09.014","url":null,"abstract":"<div><div>Free flap surgery is the gold standard for complex oral and maxillofacial reconstruction. However, complications may necessitate secondary procedures, adversely impacting patient outcomes. This review examines how preoperative radiotherapy, previous head and neck surgery, and female sex influence complication rates in free flap procedures. It also examines the input of the surgical team, methods of reconstruction & anatomical location of the defect and how these affect the secondary surgery. A literature review was conducted using systematic reviews, clinical trials, retrospective studies, and laboratory research to evaluate the impact of these three risk factors on postoperative outcomes and how surgical teams manage adverse ones. Preoperative radiotherapy increases the risk of flap failure by 1.8 times, primarily due to fibrosis and compromised vascularity, particularly when surgery is delayed beyond six weeks post-radiotherapy. Female patients demonstrate a 1.58-fold higher complication risk, potentially due to hormonal fluctuations, anemia, and menstrual cycle-related changes. A history of head and neck surgery raises complication rates by 1.64 times, attributed to scar formation, altered anatomy, and impaired vascular supply. Timing surgery appropriately following radiotherapy and considering menstrual cycles in female patients, alongside cautious flap selection in previously operated regions, may reduce complications. The data underscores the need for standardized surgical protocols and more research into sex-specific physiological factors. Tailored perioperative planning based on patient-specific risk factors is essential to minimize complications, reduce flap failure rates, and improve functional and aesthetic outcomes in oral and maxillofacial free flap reconstruction.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 365-371"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753638","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.2025.05.001
Si Hao Tang BA , Jacob E. Hoerter MD , Rijul S. Kshirsagar MD
The nasoseptal flap (NSF) has revolutionized skull base reconstruction, offering a reliable solution primarily harvested from the nasal septum, with a robust vascular supply that reduces morbidity. Our work provides a comprehensive overview of the evolution, contemporary applications, and promising future of the NSF in addressing the complex challenges associated with sinonasal malignancies. Literature review was conducted to study the past, present, and future of the use of NSF for sinonasal malignancies. The NSF's success hinges on its robust pedicle, supplied by the sphenopalatine artery, and the mucosal and structural anatomy of the nasal septum. It can be tailored to fit various defect sizes and shapes, minimizing donor site morbidity and facilitating rapid healing. Numerous modifications and extensions of the NSF have been developed to cater to various defects, broadening its applications beyond skull base reconstruction. It is increasingly used for postoperative skull base defects, iatrogenic and traumatic skull base defects, and mucosal defects beyond the skull base. Complications of the NSF, including epistaxis, nasal obstruction, and hyposmia, are manageable and minor, but rare complications such as flap necrosis and septal perforation can occur. Current research aims to optimize the use of NSF for treating sinonasal malignancies while also developing methods to effectively study their outcomes. The NSF's success and ongoing innovations in skull base reconstruction highlight its vital role in addressing sinonasal malignancies and other complex defects in the craniofacial region. Its evolution encourages continued research and collaboration to improve patient outcomes.
{"title":"History of and modern uses for the nasoseptal flap in skull base reconstruction after sinonasal malignancy","authors":"Si Hao Tang BA , Jacob E. Hoerter MD , Rijul S. Kshirsagar MD","doi":"10.1016/j.otot.2025.05.001","DOIUrl":"10.1016/j.otot.2025.05.001","url":null,"abstract":"<div><div>The nasoseptal flap (NSF) has revolutionized skull base reconstruction, offering a reliable solution primarily harvested from the nasal septum, with a robust vascular supply that reduces morbidity. Our work provides a comprehensive overview of the evolution, contemporary applications, and promising future of the NSF in addressing the complex challenges associated with sinonasal malignancies. Literature review was conducted to study the past, present, and future of the use of NSF for sinonasal malignancies. The NSF's success hinges on its robust pedicle, supplied by the sphenopalatine artery, and the mucosal and structural anatomy of the nasal septum. It can be tailored to fit various defect sizes and shapes, minimizing donor site morbidity and facilitating rapid healing. Numerous modifications and extensions of the NSF have been developed to cater to various defects, broadening its applications beyond skull base reconstruction. It is increasingly used for postoperative skull base defects, iatrogenic and traumatic skull base defects, and mucosal defects beyond the skull base. Complications of the NSF, including epistaxis, nasal obstruction, and hyposmia, are manageable and minor, but rare complications such as flap necrosis and septal perforation can occur. Current research aims to optimize the use of NSF for treating sinonasal malignancies while also developing methods to effectively study their outcomes. The NSF's success and ongoing innovations in skull base reconstruction highlight its vital role in addressing sinonasal malignancies and other complex defects in the craniofacial region. Its evolution encourages continued research and collaboration to improve patient outcomes.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 308-318"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753669","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 : 2025-09-01DOI: 10.1016/j.otot.2025.09.008
Keelin Fallon BA , Aaron Remenschneider MD, MPH, FACS
Tympanic membrane (TM) perforation is a common otologic condition that can occur across ages and genders, primarily caused by infection or trauma. Surgical repair of the TM is indicated for non-healing perforations, and tympanoplasty procedures historically were performed in the operating room (OR) under general anesthesia. Tympanoplasty techniques have changed over the years due to enhanced surgical instrumentation and surgeon comfort with the procedure. The evolution of tympanoplasty continues with a shift towards in-office procedures performed under local anesthetic in an awake patient. The report herein describes the procedural approach for an in-office tympanoplasty using a bilayer graft made from an off-the-shelf material. Patient selection is critical to ensure a successful procedure, and the surgeon should consider both patient disposition and TM perforation characteristics when deciding whether an in-office repair is appropriate. Assuming the patient and perforation are suited to the procedure and performed by an experienced surgeon, TM closure rate, hearing outcomes, and complications have been shown to be similar between in-office and OR-based repairs. Benefits of in-office procedures include avoidance of anesthesia, shorter procedural time, reduced perioperative discomfort, and lower costs.
{"title":"Tympanoplasty in the awake patient","authors":"Keelin Fallon BA , Aaron Remenschneider MD, MPH, FACS","doi":"10.1016/j.otot.2025.09.008","DOIUrl":"10.1016/j.otot.2025.09.008","url":null,"abstract":"<div><div>Tympanic membrane (TM) perforation is a common otologic condition that can occur across ages and genders, primarily caused by infection or trauma. Surgical repair of the TM is indicated for non-healing perforations, and tympanoplasty procedures historically were performed in the operating room (OR) under general anesthesia. Tympanoplasty techniques have changed over the years due to enhanced surgical instrumentation and surgeon comfort with the procedure. The evolution of tympanoplasty continues with a shift towards in-office procedures performed under local anesthetic in an awake patient. The report herein describes the procedural approach for an in-office tympanoplasty using a bilayer graft made from an off-the-shelf material. Patient selection is critical to ensure a successful procedure, and the surgeon should consider both patient disposition and TM perforation characteristics when deciding whether an in-office repair is appropriate. Assuming the patient and perforation are suited to the procedure and performed by an experienced surgeon, TM closure rate, hearing outcomes, and complications have been shown to be similar between in-office and OR-based repairs. Benefits of in-office procedures include avoidance of anesthesia, shorter procedural time, reduced perioperative discomfort, and lower costs.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 3","pages":"Pages 208-213"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374475","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 : 2025-09-01DOI: 10.1016/j.otot.2025.02.001
Grace Wester BA , Karuna Dewan MD, FACS
The tracheoesophageal prosthesis (TEP) is a common method of postlaryngectomy speech rehabilitation. While it is most commonly performed in the operating room, under general anesthesia, this can be time consuming, risky and expensive. This article discusses the procedural steps and benefits of the in-office TEP placement.
{"title":"Office-based primary tracheoesophageal puncture","authors":"Grace Wester BA , Karuna Dewan MD, FACS","doi":"10.1016/j.otot.2025.02.001","DOIUrl":"10.1016/j.otot.2025.02.001","url":null,"abstract":"<div><div>The tracheoesophageal prosthesis (TEP) is a common method of postlaryngectomy speech rehabilitation. While it is most commonly performed in the operating room, under general anesthesia, this can be time consuming, risky and expensive. This article discusses the procedural steps and benefits of the in-office TEP placement.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 3","pages":"Pages 174-179"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374468","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 : 2025-09-01DOI: 10.1016/j.otot.2025.09.006
Mark Whitaker MD, FACS, Caitlin Kroon PA-C
Myringotomy with and without tube insertion is the most commonly performed operation in otolaryngology. A majority of these are performed under general anesthesia, but for adult patients, in-office myringotomy and tube placement may be the better option. Not only does it reduce exposure to anesthesia but also helps reduce healthcare costs. We will give an overview of different ways to anesthetize the tympanic membrane, instruments needed, and procedure setup. This article will also discuss different procedure setup techniques and tips for clinicians to perform tube placement to allow for a seamless procedure.
{"title":"Surgical techniques for in-office myringotomy and tube placement in adults","authors":"Mark Whitaker MD, FACS, Caitlin Kroon PA-C","doi":"10.1016/j.otot.2025.09.006","DOIUrl":"10.1016/j.otot.2025.09.006","url":null,"abstract":"<div><div>Myringotomy with and without tube insertion is the most commonly performed operation in otolaryngology. A majority of these are performed under general anesthesia, but for adult patients, in-office myringotomy and tube placement may be the better option. Not only does it reduce exposure to anesthesia but also helps reduce healthcare costs. We will give an overview of different ways to anesthetize the tympanic membrane, instruments needed, and procedure setup. This article will also discuss different procedure setup techniques and tips for clinicians to perform tube placement to allow for a seamless procedure.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 3","pages":"Pages 194-197"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374477","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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