首页 > 最新文献

Current Opinion in Otolaryngology & Head and Neck Surgery最新文献

英文 中文
Temporal bone fracture related facial palsy: efficacy of decompression with and without grafting. 颞骨骨折引起的面瘫:减压术与非植骨术的疗效。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-26 DOI: 10.1097/MOO.0000000000001007
Amed Natour, Edward Doyle, Robert DeDio, Ravi N Samy

Purpose of review: This systematic review investigates the recent literature and aims to determine the approach, efficacy, and timing of facial nerve decompression with or without grafting in temporal bone fractures with facial palsy.

Recent findings: The surgical management of facial palsy is reserved for a small population of cases in which electrophysiologic tests indicate a poor likelihood of spontaneous recovery. The transmastoid (TM), middle cranial fossa (MCF), and translabyrinthine (TL) approaches to the facial nerve provide access to the entire intracranial and intratemporal segments of the facial nerve. In temporal bone (TB) related facial palsy, the peri-geniculate and labyrinthine portions of the facial nerve are most commonly affected by either direct trauma and/or subsequent edema. When hearing is still serviceable, the combined TM/MCF approach provides the best access to these regions. In the presence of severe sensorineural hearing loss (SNHL), the TL approach is the most appropriate for total facial nerve exploration (this can be done in conjunction with simultaneous cochlear implantation if the cochlear nerve has not been avulsed). Grade I to III House-Brackmann (HB) results can be anticipated in timely decompression of facial nerve injury caused by edema or intraneuronal hemorrhage. Grade III outcomes, with slight weakness and synkinesis, is the outcome to be expected from the use of interpositional grafts or primary neurorrhaphy. In addition to good eye care and the use of systemic steroids (if not contraindicated in the acute trauma setting), surgical decompression with or without grafting/neurorrhaphy may be offered to patients with appropriate electrophysiologic testing, physical examination findings, and radiologic localization of injury.

Summary: Surgery of the facial nerve remains an option for select patients. Here, we discuss the indications and results of treatment as well as the best surgical approach to facial nerve determined based on patient's hearing status and radiologic data. Controversy remains about whether timing of surgery (e.g., immediate vs. delayed intervention) impacts outcomes. However, no one with facial palsy due to a temporal bone fracture should be left with a complete facial paralysis.

综述目的:这篇系统性综述调查了近期的文献,旨在确定颞骨骨折伴面瘫患者面神经减压术(无论是否植皮)的方法、疗效和时机:最近的研究结果:面瘫的手术治疗仅限于电生理测试表明自发恢复可能性较低的少数病例。面神经的经乳突(TM)、中颅窝(MCF)和迷走神经(TL)入路可通达面神经的整个颅内和颞内段。在与颞骨(TB)相关的面神经麻痹中,面神经的耳廓周围和迷走神经部分最常受到直接创伤和/或后续水肿的影响。在听力尚可的情况下,TM/MCF 联合方法可为这些区域提供最佳通道。在存在严重感音神经性听力损失(SNHL)的情况下,TL 方法是最适合的面神经全探查方法(如果耳蜗神经没有撕脱,可以同时进行人工耳蜗植入术)。在对水肿或神经元内出血引起的面神经损伤进行及时减压的情况下,可预期获得 I 至 III 级 House-Brackmann (HB) 结果。III 级结果,即轻微无力和同步运动,是使用间置移植或原发性神经出血切除术的预期结果。除了良好的眼部护理和使用全身性类固醇(如果在急性创伤情况下没有禁忌症)外,还可以为有适当电生理测试、体格检查结果和放射学损伤定位的患者提供手术减压,并进行或不进行移植/神经剥脱术。在此,我们将讨论治疗的适应症和结果,以及根据患者的听力状况和放射学数据确定的面神经最佳手术方法。关于手术时机(如立即干预与延迟干预)是否会影响治疗效果,目前仍存在争议。但是,任何因颞骨骨折而导致面瘫的患者都不应该完全面瘫。
{"title":"Temporal bone fracture related facial palsy: efficacy of decompression with and without grafting.","authors":"Amed Natour, Edward Doyle, Robert DeDio, Ravi N Samy","doi":"10.1097/MOO.0000000000001007","DOIUrl":"10.1097/MOO.0000000000001007","url":null,"abstract":"<p><strong>Purpose of review: </strong>This systematic review investigates the recent literature and aims to determine the approach, efficacy, and timing of facial nerve decompression with or without grafting in temporal bone fractures with facial palsy.</p><p><strong>Recent findings: </strong>The surgical management of facial palsy is reserved for a small population of cases in which electrophysiologic tests indicate a poor likelihood of spontaneous recovery. The transmastoid (TM), middle cranial fossa (MCF), and translabyrinthine (TL) approaches to the facial nerve provide access to the entire intracranial and intratemporal segments of the facial nerve. In temporal bone (TB) related facial palsy, the peri-geniculate and labyrinthine portions of the facial nerve are most commonly affected by either direct trauma and/or subsequent edema. When hearing is still serviceable, the combined TM/MCF approach provides the best access to these regions. In the presence of severe sensorineural hearing loss (SNHL), the TL approach is the most appropriate for total facial nerve exploration (this can be done in conjunction with simultaneous cochlear implantation if the cochlear nerve has not been avulsed). Grade I to III House-Brackmann (HB) results can be anticipated in timely decompression of facial nerve injury caused by edema or intraneuronal hemorrhage. Grade III outcomes, with slight weakness and synkinesis, is the outcome to be expected from the use of interpositional grafts or primary neurorrhaphy. In addition to good eye care and the use of systemic steroids (if not contraindicated in the acute trauma setting), surgical decompression with or without grafting/neurorrhaphy may be offered to patients with appropriate electrophysiologic testing, physical examination findings, and radiologic localization of injury.</p><p><strong>Summary: </strong>Surgery of the facial nerve remains an option for select patients. Here, we discuss the indications and results of treatment as well as the best surgical approach to facial nerve determined based on patient's hearing status and radiologic data. Controversy remains about whether timing of surgery (e.g., immediate vs. delayed intervention) impacts outcomes. However, no one with facial palsy due to a temporal bone fracture should be left with a complete facial paralysis.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial introductions. 编辑介绍。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-05 DOI: 10.1097/MOO.0000000000001003
{"title":"Editorial introductions.","authors":"","doi":"10.1097/MOO.0000000000001003","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001003","url":null,"abstract":"","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Newborn congenital cytomegalovirus screening and hearing outcomes: a systematic review of current literature. 新生儿先天性巨细胞病毒筛查与听力结果:当前文献的系统性回顾。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-26 DOI: 10.1097/MOO.0000000000000996
Sarah A Pollick, Yusra Mansour, Megan H Pesch

Purpose of review: The purpose of this review is to summarize the very recent literature surrounding hearing outcomes of children with congenital cytomegalovirus (cCMV) detected through systematic screening programs.

Recent findings: There are several different approaches to cCMV screening including forms of targeted vs. universal screening of newborns as well as maternally-derived prenatal testing. However, many studies fail to document hearing-related outcomes both in the newborn period and further into childhood when late-onset sensorineural hearing loss (SNHL) can occur. This systematic review included studies of neonates screened for cCMV reporting hearing outcomes for at least one point in time. Hearing targeted screening appeared the most widely reported for detection of unilateral and bilateral SNHL in those with cCMV. A few studies examined these clinical findings in relation to antiviral treatment.

Summary: Congenital CMV is an important and common cause of childhood hearing loss. Newborn screening programs may expand opportunities for early diagnosis and treatment of the infection and its sequelae.

综述目的:本综述旨在总结通过系统筛查计划发现患有先天性巨细胞病毒(cCMV)的儿童听力结果的最新文献:cCMV 筛查有几种不同的方法,包括对新生儿进行有针对性的筛查和普遍筛查,以及产前母体检测。然而,许多研究都没有记录新生儿期和儿童期的听力相关结果,因为儿童期可能会出现迟发性感音神经性听力损失 (SNHL)。本系统性综述纳入了对新生儿进行 cCMV 筛查的研究,这些研究报告了至少一个时间点的听力结果。有针对性的听力筛查似乎是用于检测 cCMV 患儿单侧和双侧 SNHL 的最广泛报道。小结:先天性巨细胞病毒是导致儿童听力损失的一个重要且常见的原因。新生儿筛查计划可为感染及其后遗症的早期诊断和治疗提供更多机会。
{"title":"Newborn congenital cytomegalovirus screening and hearing outcomes: a systematic review of current literature.","authors":"Sarah A Pollick, Yusra Mansour, Megan H Pesch","doi":"10.1097/MOO.0000000000000996","DOIUrl":"10.1097/MOO.0000000000000996","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to summarize the very recent literature surrounding hearing outcomes of children with congenital cytomegalovirus (cCMV) detected through systematic screening programs.</p><p><strong>Recent findings: </strong>There are several different approaches to cCMV screening including forms of targeted vs. universal screening of newborns as well as maternally-derived prenatal testing. However, many studies fail to document hearing-related outcomes both in the newborn period and further into childhood when late-onset sensorineural hearing loss (SNHL) can occur. This systematic review included studies of neonates screened for cCMV reporting hearing outcomes for at least one point in time. Hearing targeted screening appeared the most widely reported for detection of unilateral and bilateral SNHL in those with cCMV. A few studies examined these clinical findings in relation to antiviral treatment.</p><p><strong>Summary: </strong>Congenital CMV is an important and common cause of childhood hearing loss. Newborn screening programs may expand opportunities for early diagnosis and treatment of the infection and its sequelae.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative management following endoscopic skull base surgery. 内窥镜颅底手术后的术后管理。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-09-12 DOI: 10.1097/MOO.0000000000001010
Domen Vozel, Jure Urbančič

Purpose of review: The purpose of this opinion is to review current evidence regarding postoperative management following endoscopic skull base surgery.

Recent findings: Postoperative management encompasses consideration of level of care, laboratory tests, analgetic and antiemetic therapy, antibiotic, antithrombotic and antiepileptic prophylaxis, pharmacological and nonpharmacological cerebrospinal fluid (CSF) pressure reduction measures, including CSF diversion, activity restrictions, nasal packing removal, nasal debridement and toilet, nasal glucocorticoid administration, positive pressure ventilation, imaging, CSF leak diagnosis, and future perspectives.

Summary: Although significant effort has been put into research of postoperative measures after endoscopic skull-base surgery, there is a heterogeneity of practices and deficit of high-level studies, which would enable highly powered systematic reviews and meta-analyses.

综述目的:本观点旨在回顾内窥镜颅底手术术后管理的现有证据:术后管理包括考虑护理水平、实验室检查、止痛和止吐治疗、抗生素、抗血栓和抗癫痫预防、药物和非药物脑脊液(CSF)减压措施,包括 CSF 分流、活动限制、鼻腔填料去除、鼻腔清创和冲洗、鼻腔糖皮质激素给药、正压通气、影像学、CSF 漏诊断和未来展望。小结:尽管对内窥镜颅底手术后的术后措施进行了大量研究,但仍存在实践的异质性和高水平研究的不足,而高水平研究可以进行高效力的系统综述和荟萃分析。
{"title":"Postoperative management following endoscopic skull base surgery.","authors":"Domen Vozel, Jure Urbančič","doi":"10.1097/MOO.0000000000001010","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001010","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this opinion is to review current evidence regarding postoperative management following endoscopic skull base surgery.</p><p><strong>Recent findings: </strong>Postoperative management encompasses consideration of level of care, laboratory tests, analgetic and antiemetic therapy, antibiotic, antithrombotic and antiepileptic prophylaxis, pharmacological and nonpharmacological cerebrospinal fluid (CSF) pressure reduction measures, including CSF diversion, activity restrictions, nasal packing removal, nasal debridement and toilet, nasal glucocorticoid administration, positive pressure ventilation, imaging, CSF leak diagnosis, and future perspectives.</p><p><strong>Summary: </strong>Although significant effort has been put into research of postoperative measures after endoscopic skull-base surgery, there is a heterogeneity of practices and deficit of high-level studies, which would enable highly powered systematic reviews and meta-analyses.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atypical facial clefts: Tessier number 3 and 4 clefts. 非典型面裂:Tessier 3 号和 4 号裂隙。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-10 DOI: 10.1097/MOO.0000000000000985
Alyssa M Civantos, Pramila Shakya, David A Shaye

Purpose of review: Tessier number 3 and 4 clefts result from failed fusion of facial processes during embryogenesis, and cause functional, psychosocial, and cosmetic morbidity. Given their rarity and heterogeneity, they present a unique challenge to the reconstructive surgeon, with limited literature for guidance. The purpose of this update is to summarize Tessier number 3 and 4 clefts with a focus on recent literature and expert opinion.

Recent findings: The incidence of atypical facial clefts has been estimated between 1.4 and 4.9 per 100 000 live births. Several retrospective chart reviews have been published in recent years; however, the epidemiologic data remains limited. Surgical management must be individualized and guided by classic reconstructive principles. The goal of surgery is to return the three soft tissue components (lip, nasomalar, and eyelid) to their proper anatomical location.

Summary: Tessier number 3 and 4 clefts are rare, demonstrate a wide spectrum of clinical presentation, and remain challenging to gain a breadth of experience for any single surgeon. They are classified based on their location along well defined anatomical axes. Component repair is performed with attention to the lip, nasomalar, and eyelid regions to restore facial symmetry and function.

综述的目的:Tessier 3 号和 4 号裂隙是由于胚胎发育过程中面部突起融合失败造成的,会导致功能、社会心理和外观方面的疾病。鉴于它们的罕见性和异质性,它们给整形外科医生带来了独特的挑战,而可提供指导的文献却很有限。本次更新的目的是总结 Tessier 3 号和 4 号裂隙,重点关注最新文献和专家意见:据估计,非典型面裂的发病率为每 10 万活产 1.4 至 4.9 例。近年来发表了多篇回顾性病历,但流行病学数据仍然有限。手术治疗必须因人而异,并遵循经典的重建原则。手术的目的是将三个软组织部分(唇、鼻唇沟和眼睑)恢复到正确的解剖位置。摘要:Tessier 3 号和 4 号唇裂非常罕见,临床表现多种多样,任何一名外科医生都难以获得丰富的经验。它们是根据其沿明确解剖轴线的位置进行分类的。进行组件修复时要注意唇部、鼻唇沟和眼睑区域,以恢复面部的对称性和功能。
{"title":"Atypical facial clefts: Tessier number 3 and 4 clefts.","authors":"Alyssa M Civantos, Pramila Shakya, David A Shaye","doi":"10.1097/MOO.0000000000000985","DOIUrl":"10.1097/MOO.0000000000000985","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tessier number 3 and 4 clefts result from failed fusion of facial processes during embryogenesis, and cause functional, psychosocial, and cosmetic morbidity. Given their rarity and heterogeneity, they present a unique challenge to the reconstructive surgeon, with limited literature for guidance. The purpose of this update is to summarize Tessier number 3 and 4 clefts with a focus on recent literature and expert opinion.</p><p><strong>Recent findings: </strong>The incidence of atypical facial clefts has been estimated between 1.4 and 4.9 per 100 000 live births. Several retrospective chart reviews have been published in recent years; however, the epidemiologic data remains limited. Surgical management must be individualized and guided by classic reconstructive principles. The goal of surgery is to return the three soft tissue components (lip, nasomalar, and eyelid) to their proper anatomical location.</p><p><strong>Summary: </strong>Tessier number 3 and 4 clefts are rare, demonstrate a wide spectrum of clinical presentation, and remain challenging to gain a breadth of experience for any single surgeon. They are classified based on their location along well defined anatomical axes. Component repair is performed with attention to the lip, nasomalar, and eyelid regions to restore facial symmetry and function.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence in maxillofacial and facial plastic and reconstructive surgery. 人工智能在颌面部整形和重建手术中的应用。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-29 DOI: 10.1097/MOO.0000000000000983
Ethan Fung, Dhruv Patel, Sherard Tatum

Purpose of review: To provide a current review of artificial intelligence and its subtypes in maxillofacial and facial plastic surgery including a discussion of implications and ethical concerns.

Recent findings: Artificial intelligence has gained popularity in recent years due to technological advancements. The current literature has begun to explore the use of artificial intelligence in various medical fields, but there is limited contribution to maxillofacial and facial plastic surgery due to the wide variance in anatomical facial features as well as subjective influences. In this review article, we found artificial intelligence's roles, so far, are to automatically update patient records, produce 3D models for preoperative planning, perform cephalometric analyses, and provide diagnostic evaluation of oropharyngeal malignancies.

Summary: Artificial intelligence has solidified a role in maxillofacial and facial plastic surgery within the past few years. As high-quality databases expand with more patients, the role for artificial intelligence to assist in more complicated and unique cases becomes apparent. Despite its potential, ethical questions have been raised that should be noted as artificial intelligence continues to thrive. These questions include concerns such as compromise of the physician-patient relationship and healthcare justice.

综述的目的:对人工智能及其亚型在颌面部整形手术中的应用进行综述,包括对其影响和伦理问题的讨论:近年来,随着技术的进步,人工智能越来越受欢迎。目前的文献已开始探索人工智能在各个医学领域的应用,但由于面部解剖特征的差异很大以及主观因素的影响,人工智能在颌面部整形外科领域的应用还很有限。在这篇综述文章中,我们发现到目前为止,人工智能的作用主要是自动更新患者记录、制作用于术前规划的三维模型、进行头颅测量分析以及提供口咽恶性肿瘤的诊断评估。随着高质量数据库中患者数量的增加,人工智能在协助处理更复杂、更特殊病例方面的作用变得显而易见。尽管人工智能潜力巨大,但随着人工智能的不断发展,人们也提出了一些应该注意的伦理问题。这些问题包括对医患关系和医疗公正的损害。
{"title":"Artificial intelligence in maxillofacial and facial plastic and reconstructive surgery.","authors":"Ethan Fung, Dhruv Patel, Sherard Tatum","doi":"10.1097/MOO.0000000000000983","DOIUrl":"10.1097/MOO.0000000000000983","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide a current review of artificial intelligence and its subtypes in maxillofacial and facial plastic surgery including a discussion of implications and ethical concerns.</p><p><strong>Recent findings: </strong>Artificial intelligence has gained popularity in recent years due to technological advancements. The current literature has begun to explore the use of artificial intelligence in various medical fields, but there is limited contribution to maxillofacial and facial plastic surgery due to the wide variance in anatomical facial features as well as subjective influences. In this review article, we found artificial intelligence's roles, so far, are to automatically update patient records, produce 3D models for preoperative planning, perform cephalometric analyses, and provide diagnostic evaluation of oropharyngeal malignancies.</p><p><strong>Summary: </strong>Artificial intelligence has solidified a role in maxillofacial and facial plastic surgery within the past few years. As high-quality databases expand with more patients, the role for artificial intelligence to assist in more complicated and unique cases becomes apparent. Despite its potential, ethical questions have been raised that should be noted as artificial intelligence continues to thrive. These questions include concerns such as compromise of the physician-patient relationship and healthcare justice.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of telehealth in the delivery of oral and maxillofacial surgery services at a level 6 hospital in New South Wales Australia during COVID-19 - the John Hunter Hospital experience: a commentary, review and cautionary tale for the future. COVID-19 期间远程医疗在澳大利亚新南威尔士州一家六级医院提供口腔颌面外科服务中的作用--约翰-亨特医院的经验:评论、回顾和对未来的警示。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-06 DOI: 10.1097/MOO.0000000000000978
Annabelle Welham, Eileen Tan-Gore, Rebekah Taylor

Purpose of review: The objective of this article is to understand the uptake in use of Telehealth services during the COVID-19 pandemic as a way to provide compelling impetus for further research and promotion of Telehealth in general. A data review of Outpatient Department data from 2020 to 2023, as compiled by the Surgical Outcomes improvement Unit.

Recent findings: Telehealth was widely adopted during the COVID-19 pandemic for clinicians to provide healthcare to patients whilst adhering to strict lockdown guidelines aimed at limiting exposure and spread of the respiratory virus. There has been minimal analysis, however, of the ethical and legal implications of telemedicine. Whilst it seems that access to care is improved via telehealth, there are subtle, inherent barriers intrinsic to it.

Summary: There was a significant increase in the use of audio and audiovisual aids in the delivery of Oral and Maxillofacial Outpatient care during the COVID-19 period. Further analysis and improvements need to be made to the system before it can be considered as sufficient and adequate. Where there is rapid adoption of Telehealth in the delivery of Oral and Maxillofacial Surgery Services, there must be concurrent rigorous review and update of systems in order to address the key areas of patient safety and accuracy of treatment.

审查目的:本文旨在了解 COVID-19 大流行期间远程医疗服务的使用情况,从而为进一步研究和推广远程医疗提供有力的推动力。本文回顾了由外科成果改进小组(Surgical Outcomes improvement Unit)编制的 2020 年至 2023 年门诊部数据:在 COVID-19 大流行期间,远程医疗被广泛应用于临床医生为患者提供医疗服务,同时严格遵守旨在限制呼吸道病毒暴露和传播的封锁准则。然而,对远程医疗的伦理和法律影响的分析却少之又少。总结:在 COVID-19 期间,口腔颌面门诊护理中音频和视听辅助工具的使用显著增加。需要对该系统进行进一步分析和改进,才能认为其足够充分。在快速采用远程医疗提供口腔颌面外科服务的地方,必须同时对系统进行严格审查和更新,以解决患者安全和治疗准确性等关键问题。
{"title":"The role of telehealth in the delivery of oral and maxillofacial surgery services at a level 6 hospital in New South Wales Australia during COVID-19 - the John Hunter Hospital experience: a commentary, review and cautionary tale for the future.","authors":"Annabelle Welham, Eileen Tan-Gore, Rebekah Taylor","doi":"10.1097/MOO.0000000000000978","DOIUrl":"10.1097/MOO.0000000000000978","url":null,"abstract":"<p><strong>Purpose of review: </strong>The objective of this article is to understand the uptake in use of Telehealth services during the COVID-19 pandemic as a way to provide compelling impetus for further research and promotion of Telehealth in general. A data review of Outpatient Department data from 2020 to 2023, as compiled by the Surgical Outcomes improvement Unit.</p><p><strong>Recent findings: </strong>Telehealth was widely adopted during the COVID-19 pandemic for clinicians to provide healthcare to patients whilst adhering to strict lockdown guidelines aimed at limiting exposure and spread of the respiratory virus. There has been minimal analysis, however, of the ethical and legal implications of telemedicine. Whilst it seems that access to care is improved via telehealth, there are subtle, inherent barriers intrinsic to it.</p><p><strong>Summary: </strong>There was a significant increase in the use of audio and audiovisual aids in the delivery of Oral and Maxillofacial Outpatient care during the COVID-19 period. Further analysis and improvements need to be made to the system before it can be considered as sufficient and adequate. Where there is rapid adoption of Telehealth in the delivery of Oral and Maxillofacial Surgery Services, there must be concurrent rigorous review and update of systems in order to address the key areas of patient safety and accuracy of treatment.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Posterior tongue tie: that is a thing? 后舌系带:有这回事吗?
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-10 DOI: 10.1097/MOO.0000000000000982
Kaelan Black

Purpose of review: The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.

Recent findings: Recent findings show that the posterior tongue tie may play a role in effective breast feeding.

Summary: Ankyloglossia is the term used for the restriction of the movement of the tongue that impairs certain functions such as breastfeeding or bottle feeding, feeding with solids, and speech. Cadaver studies have shown that there can be a restriction of the tongue and oral tissues in some people relative to others. In some breast-feeding studies, releasing the posterior tie has been shown to improve certain aspects of tongue movement. There is little evidence for or against posterior tongue ties contributing to other problems such as speech and solid feeding. This article goes into depth about the current studies on posterior ankyloglossia.

综述目的:本综述旨在研究目前对舌后系带的研究,以及它与母乳喂养、固体食物喂养和语言的关系:摘要:舌后系带是指舌头活动受限,从而影响母乳喂养或奶瓶喂养、固体食物喂养和语言表达等功能。尸体研究表明,与其他人相比,有些人的舌头和口腔组织可能会受到限制。在一些母乳喂养研究中,松开后扎带可以改善舌头某些方面的活动。目前几乎没有证据证明舌后系带会导致语言和固体喂养等其他问题。本文将深入探讨目前有关后系舌的研究。
{"title":"Posterior tongue tie: that is a thing?","authors":"Kaelan Black","doi":"10.1097/MOO.0000000000000982","DOIUrl":"10.1097/MOO.0000000000000982","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.</p><p><strong>Recent findings: </strong>Recent findings show that the posterior tongue tie may play a role in effective breast feeding.</p><p><strong>Summary: </strong>Ankyloglossia is the term used for the restriction of the movement of the tongue that impairs certain functions such as breastfeeding or bottle feeding, feeding with solids, and speech. Cadaver studies have shown that there can be a restriction of the tongue and oral tissues in some people relative to others. In some breast-feeding studies, releasing the posterior tie has been shown to improve certain aspects of tongue movement. There is little evidence for or against posterior tongue ties contributing to other problems such as speech and solid feeding. This article goes into depth about the current studies on posterior ankyloglossia.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on using buccal myomucosal flaps for patients with cleft palate and velopharyngeal insufficiency: primary and secondary interventions. 关于使用颊粘膜瓣治疗腭裂和咽发育不全患者的最新进展:主要和次要干预措施。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI: 10.1097/MOO.0000000000000981
Alexander P Marston, Travis T Tollefson

Purpose of review: This review aims to examine the indications and anatomical circumstances for when to optimally incorporate buccal myomucosal flaps (BMFs) into palatal surgical reconstruction.

Recent findings: Studies examining outcomes following primary cleft palate repair with incorporation of BMF have demonstrated excellent speech outcomes and low rates of fistula. Furthermore, some reports cite an association of buccal flap use with reduced midface hypoplasia and the need for later orthognathic surgery. When used for secondary speech surgery, BMFs have been shown to lead to speech improvements across multiple outcome measures. Advantages of BMF techniques over conventionally described pharyngeal flap and pharyngoplasty procedures include significant lengthening of the velum, favorable repositioning of the levator muscular sling, and lower rates of obstructive sleep apnea.

Summary: Although the published data demonstrate excellent outcomes with use of BMFs for primary and secondary palatal surgery, there are limited data to conclude superiority over the traditional, more extensively investigated surgical techniques. The authors of this review agree with the evidence that BMF techniques can be useful in primary palatoplasty for congenitally wide clefts, secondary speech surgery for large velopharyngeal gaps, and/or in individuals with a predisposition for airway obstruction from traditional approaches.

综述目的:本综述旨在研究何时将颊黏膜瓣(BMF)最佳地用于腭裂手术重建的适应症和解剖学情况:最近的研究结果:对采用颊黏膜瓣进行初级腭裂修复术后效果的研究表明,腭裂修复术后的语言表达效果极佳,瘘管发生率较低。此外,一些报告指出,使用颊瓣可减少面中部发育不良和后期正颌手术的需要。在进行二次言语手术时,颊颌瓣已被证明能在多种结果测量中改善言语。与传统的咽皮瓣和咽成形术相比,BMF 技术的优势包括可显著延长伶牙利齿,有利地重新定位提上睑肌吊带,以及降低阻塞性睡眠呼吸暂停的发生率。摘要:尽管已发表的数据显示,使用 BMF 进行初级和次级腭部手术可获得极佳的疗效,但与传统的、经过更广泛研究的手术技术相比,能得出优越性结论的数据非常有限。本综述的作者同意有证据表明,BMF 技术可用于治疗先天性宽裂的初级腭成形术、治疗巨大咽鼓管间隙的二次言语手术,以及/或用于传统方法易导致气道阻塞的个体。
{"title":"Update on using buccal myomucosal flaps for patients with cleft palate and velopharyngeal insufficiency: primary and secondary interventions.","authors":"Alexander P Marston, Travis T Tollefson","doi":"10.1097/MOO.0000000000000981","DOIUrl":"10.1097/MOO.0000000000000981","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to examine the indications and anatomical circumstances for when to optimally incorporate buccal myomucosal flaps (BMFs) into palatal surgical reconstruction.</p><p><strong>Recent findings: </strong>Studies examining outcomes following primary cleft palate repair with incorporation of BMF have demonstrated excellent speech outcomes and low rates of fistula. Furthermore, some reports cite an association of buccal flap use with reduced midface hypoplasia and the need for later orthognathic surgery. When used for secondary speech surgery, BMFs have been shown to lead to speech improvements across multiple outcome measures. Advantages of BMF techniques over conventionally described pharyngeal flap and pharyngoplasty procedures include significant lengthening of the velum, favorable repositioning of the levator muscular sling, and lower rates of obstructive sleep apnea.</p><p><strong>Summary: </strong>Although the published data demonstrate excellent outcomes with use of BMFs for primary and secondary palatal surgery, there are limited data to conclude superiority over the traditional, more extensively investigated surgical techniques. The authors of this review agree with the evidence that BMF techniques can be useful in primary palatoplasty for congenitally wide clefts, secondary speech surgery for large velopharyngeal gaps, and/or in individuals with a predisposition for airway obstruction from traditional approaches.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing massive palatial defect secondary to palatoplasty failures: an in-depth analysis. 腭成形术失败后大面积腭缺损的处理:深入分析。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-02-23 DOI: 10.1097/MOO.0000000000000968
Madison Boot, Ryan Winters

Purpose of review: Massive palatal defects resulting from palatoplasty failures arising from cleft palate repair complications present ongoing challenges in clinical practice. The purpose of this review is to provide up-to-date insights into aetiology, risk factors, surgical techniques, and adjunctive therapies, aiming to enhance the understanding of such complex cases, and optimize patient outcomes.

Recent findings: Primary palatoplasty has fistula recurrence rates ranging from 2.4% to 55%. Factors such as cleft width, surgical repair method, and patient characteristics, influence the likelihood of failure. Classifications such as the Pakistan Comprehensive Classification and Richardson's criteria aid in assessing defects. Surgical options range from local flaps and revision palatoplasty to regional flaps (e.g., buccinator myomucosal, facial artery-based flaps, tongue flaps, nasal septal flaps) to free microvascular flaps. Alternative approaches include obturator prostheses, and acellular dermal matrix has been used as an adjuvant to multiple repair techniques. Hyperbaric oxygen therapy has emerged as an adjunctive therapy to enhance tissue healing.

Summary: This comprehensive review underscores the intricate challenges associated with massive palatal defects resulting from palatoplasty failures. The diverse range of surgical and nonsurgical options emphasizes the importance of patient-centric, individualized approaches. Practitioners, armed with evidence-based insights, can navigate these complexities, offering tailored interventions for improved patient outcomes.

审查目的:腭裂修复并发症导致的腭成形术失败造成的巨大腭部缺损一直是临床实践中的难题。本综述旨在提供有关病因、风险因素、手术技术和辅助疗法的最新见解,旨在加深对此类复杂病例的理解,优化患者预后:原发性腭成形术的瘘管复发率从 2.4% 到 55% 不等。裂隙宽度、手术修复方法和患者特征等因素都会影响失败的可能性。巴基斯坦综合分类法和理查森标准等分类有助于评估缺陷。手术方法包括局部皮瓣和翻修腭成形术、区域皮瓣(如颊粘膜瓣、面部动脉皮瓣、舌皮瓣、鼻中隔皮瓣)以及游离微血管瓣。替代方法包括闭孔器假体,而非细胞真皮基质已被用作多种修复技术的辅助手段。高压氧疗法已成为促进组织愈合的辅助疗法。摘要:本综述强调了腭成形术失败导致的巨大腭部缺损所带来的复杂挑战。多种多样的手术和非手术疗法强调了以患者为中心的个性化治疗方法的重要性。医生在掌握循证医学知识后,就能驾驭这些复杂问题,为改善患者预后提供量身定制的干预措施。
{"title":"Managing massive palatial defect secondary to palatoplasty failures: an in-depth analysis.","authors":"Madison Boot, Ryan Winters","doi":"10.1097/MOO.0000000000000968","DOIUrl":"10.1097/MOO.0000000000000968","url":null,"abstract":"<p><strong>Purpose of review: </strong>Massive palatal defects resulting from palatoplasty failures arising from cleft palate repair complications present ongoing challenges in clinical practice. The purpose of this review is to provide up-to-date insights into aetiology, risk factors, surgical techniques, and adjunctive therapies, aiming to enhance the understanding of such complex cases, and optimize patient outcomes.</p><p><strong>Recent findings: </strong>Primary palatoplasty has fistula recurrence rates ranging from 2.4% to 55%. Factors such as cleft width, surgical repair method, and patient characteristics, influence the likelihood of failure. Classifications such as the Pakistan Comprehensive Classification and Richardson's criteria aid in assessing defects. Surgical options range from local flaps and revision palatoplasty to regional flaps (e.g., buccinator myomucosal, facial artery-based flaps, tongue flaps, nasal septal flaps) to free microvascular flaps. Alternative approaches include obturator prostheses, and acellular dermal matrix has been used as an adjuvant to multiple repair techniques. Hyperbaric oxygen therapy has emerged as an adjunctive therapy to enhance tissue healing.</p><p><strong>Summary: </strong>This comprehensive review underscores the intricate challenges associated with massive palatal defects resulting from palatoplasty failures. The diverse range of surgical and nonsurgical options emphasizes the importance of patient-centric, individualized approaches. Practitioners, armed with evidence-based insights, can navigate these complexities, offering tailored interventions for improved patient outcomes.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Current Opinion in Otolaryngology & Head and Neck Surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1