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

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The surgical future is here, but it is not evenly distributed. 外科手术的未来已经到来,但分布并不均衡。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.1097/MOO.0000000000000984
David A Shaye
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引用次数: 0
Use of piezoelectric instrumentation in craniofacial surgery. 在颅面外科手术中使用压电仪器。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI: 10.1097/MOO.0000000000000986
Sarah Bessen, Shekhar K Gadkaree, Adeeb Derakhshan

Purpose of review: The use of piezoelectric instrumentation is increasingly recognized as an alternative to traditional bone-cutting techniques across a wide array of surgeries. Here, we provide an overview of the technique, including device principles, benefits, and drawbacks. We also review its use in craniofacial surgery.

Recent findings: Piezoelectric surgery is a minimally invasive bone-cutting system with lower risk of damage to surrounding soft tissue structures. Indications for its use are rapidly expanding across multiple fields, including craniofacial surgery. To date, piezosurgical techniques have been most widely adopted and studied in the contexts of rhinoplasty, orthognathic surgery, and cranioplasty in craniosynostosis. Piezosurgery can facilitate more precise and consistent osteotomies while decreasing morbidities associated with traditional osteotomy techniques. Primary limitations include cost and concerns regarding increased operative times secondary to operator learning curves and decreased cutting efficiency.

Summary: Piezoelectric surgery represents an alternative to traditional bone-cutting modalities to improve precision, consistency, and safety of osteotomies. Further research is needed to better understand the efficacy of the technique as well as potential for additional applications.

审查目的:越来越多的人认识到使用压电器械可以替代传统的切骨技术,适用于各种手术。在此,我们将概述该技术,包括设备原理、优点和缺点。我们还回顾了该技术在颅颌面手术中的应用:压电手术是一种微创切骨系统,对周围软组织结构造成损伤的风险较低。压电手术的使用范围正在迅速扩大,涉及多个领域,包括颅面外科。迄今为止,压电外科技术在鼻成形术、正颌外科手术和颅骨综合症的颅骨成形术中得到了最广泛的应用和研究。压电外科技术可使截骨更加精确和一致,同时降低与传统截骨技术相关的发病率。主要的局限性包括成本以及因操作者学习曲线和切割效率下降而导致手术时间增加的担忧。摘要:压电手术是传统切骨方式的替代方案,可提高截骨的精确性、一致性和安全性。要更好地了解该技术的功效以及其他应用的潜力,还需要进一步的研究。
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引用次数: 0
Management of large head and neck defects in the vessel-depleted neck. 处理颈部血管缺损的巨大头颈部缺损。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.1097/MOO.0000000000000980
Lindsey Shehee, Danielle Bottalico, Brandon Prendes

Purpose of review: Surgery, radiation, and chemotherapy are often utilized in the treatment of head and neck cancer. These treatments can cause extensive scarring within the neck and can limit the viability of recipient vessels for further microvascular reconstruction. Patients with vessel-depleted necks provide a significant challenge for microvascular surgeons and are a topic of much discussion in the field.

Recent findings: While reconstruction in the vessel-depleted neck is an active area of interest, the patient population is rare. Therefore, single institution series with small numbers comprise the majority of published literature. Recent publications describe techniques for identifying adequate recipient vessel options outside of the field of treatment with excellent free flap outcomes. Further, recent summary articles describe techniques for addressing issues with pedicle length that can arise when using vessels that are far from the defect to be reconstructed.

Summary: When viable vessel options are available within the treatment field, these recipient vessels can be used with good reliability and free flap success. If in-field recipient vessels are not available, minimal access incisions can be used to identify superficial temporal, angular, contralateral facial, or transverse cervical vessels. Further away from the treatment field, internal mammary vessels can be harvested through open or robotic approaches. If the use of these distant vessels creates issues with pedicle length, interposition vein grafts, arteriovenous (AV) loops, or flow-through flaps can be used to augment vessel length.

审查目的:头颈部癌症的治疗通常采用手术、放疗和化疗。这些治疗方法会在颈部造成广泛的瘢痕,并会限制受体血管进一步进行微血管重建的可行性。颈部血管缺损患者给微血管外科医生带来了巨大挑战,也是该领域讨论较多的话题:最近的研究结果:虽然颈部血管缺损的重建是一个备受关注的领域,但这种患者却很少见。因此,在已发表的文献中,大多数都是单个机构的小样本病例。最近发表的文章介绍了在治疗区域外寻找足够受体血管的技术,并取得了很好的游离皮瓣效果。此外,最近的总结性文章介绍了如何解决在使用远离待重建缺损的血管时可能出现的瓣蒂长度问题的技术。如果没有治疗区域内的受体血管,可以使用最小切口来确定颞浅血管、角血管、对侧面部血管或颈横血管。在距离治疗区域更远的地方,可以通过开放式或机器人方法采集乳腺内血管。如果使用这些远处的血管会造成血管蒂长度的问题,则可以使用插位静脉移植、动静脉环或穿流皮瓣来增加血管长度。
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引用次数: 0
Invasive fungal rhinosinusitis: current evidence and research opportunities. 侵袭性真菌性鼻炎:现有证据与研究机会。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-07-19 DOI: 10.1097/MOO.0000000000000993
Jenny Ji, Lauren T Roland

Purpose of review: To summarize the evidence surrounding diagnosis, treatment, prognosis, and surveillance of patients with acute invasive fungal sinusitis (AIFS) and discuss future research needs.

Recent findings: New risk factors for AIFS such as COVID have been identified, and a new prognostic staging system has been developed.

Summary: Most patients who develop AIFS are immunocompromised, with the majority having a history of diabetes or a hematologic malignancy. Unfortunately, there are not any highly sensitive and specific diagnostic tools. Therefore, a combination of signs and symptoms, imaging, endoscopy, biopsy, and labs should be used to diagnosis AIFS. Although surgery and systemic antifungals are known to improve outcomes, there is limited data on time to intervention, duration of antifungals, and surveillance patterns. There is also limited information on factors that can predict outcomes in AIFS patients. However, sensory/perceptual changes, prolonged neutropenia duration, and comorbidity burden may be associated with a poor prognosis.

综述的目的:总结与急性侵袭性真菌性鼻窦炎(AIFS)患者的诊断、治疗、预后和监测有关的证据,并讨论未来的研究需求:摘要:大多数罹患急性侵袭性真菌性鼻窦炎的患者免疫力低下,大多数患者有糖尿病或血液系统恶性肿瘤病史。遗憾的是,目前还没有高度敏感和特异的诊断工具。因此,诊断 AIFS 时应综合使用体征和症状、影像学检查、内窥镜检查、活组织检查和实验室检查。虽然已知手术和全身性抗真菌药物可改善预后,但有关干预时间、抗真菌药物持续时间和监测模式的数据却很有限。有关 AIFS 患者预后因素的信息也很有限。然而,感觉/知觉改变、中性粒细胞减少持续时间延长以及合并症负担可能与预后不良有关。
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引用次数: 0
Transitions in tracheostomy care: from childhood to adulthood. 气管造口护理的过渡:从童年到成年。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2023-08-04 DOI: 10.1097/MOO.0000000000000919
Louise Edwards, Jackie McRae

Purpose of review: The purpose of this review is to explore the evidence around children and young people who require a tracheostomy and transition into adult services, reflecting on the challenges and considerations for clinical practice as these needs increase.

Recent findings: There are a lack of data on the incidence and prevalence of children and young people with a tracheostomy transitioning to adult services for ongoing care. There are significant variations in care needs, technology and previous experiences that demand more than a simple handover process. Examples of service models that support the transition of care exist, however these lack specificity for children and young people with a tracheostomy.

Summary: Further exploration of the needs of children and young people requiring airway technology is indicated, particularly considering the short and long-term education, health, and social care needs.

综述目的:本综述旨在探讨需要气管造口术的儿童和青少年向成人服务过渡的相关证据,反思随着这些需求的增加,临床实践所面临的挑战和需要考虑的因素:目前缺乏有关气管造口术儿童和青少年过渡到成人服务机构接受持续护理的发生率和流行率的数据。在护理需求、技术和以往经验方面存在很大差异,因此需要的不仅仅是一个简单的移交过程。目前已有支持护理过渡的服务模式实例,但这些模式缺乏针对气管造口术儿童和青少年的特殊性:需要进一步探讨需要气道技术的儿童和青少年的需求,特别是考虑到短期和长期的教育、健康和社会护理需求。
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引用次数: 0
'Seeing is believing' - gender disparities in otolaryngology-head and neck surgery in Africa: a narrative review. 眼见为实"--非洲耳鼻咽喉头颈外科的性别差异:叙述性综述。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-15 DOI: 10.1097/MOO.0000000000000964
Amina Seguya, Fiona Kabagenyi, Sharon Ovnat Tamir

Purpose of review: Various factors affect otolaryngology - head and neck surgery (OHNS) services in low- and middle-income countries (LMICs); including inadequate infrastructure, limited academic positions, unfavorable hospital research policies, and traditional misconceptions about gender and surgery, among others. Although gender inequalities exist globally, they are particularly pronounced in LMICs, especially in Africa.

Recent findings: A comparative narrative literature review for relevant manuscripts from January 1, 2017 to through January 10th, 2024, using PubMed, Embase and Google Scholar for articles from the United States/Canada and Africa was done. 195 relevant articles were from the United States/Canada, while only 5 were from Africa and only 1 manuscript was relevant to OHNS. The reviewed articles reported that gender disparities exist in medical training, authorship, and career advancement. We highlight possible solutions to some of these disparities to promote a more gender-diversified workforce in OHNS in Africa as well as all over the world.

Summary: Additional studies on gender disparities in Africa, are needed. These studies will highlight need for inclusive policies, structured and accessible mentorship programs; through which these disparities can be highlighted and addressed. This will in the long run ensure sustainability of OHNS care in LMICs.

审查目的:影响中低收入国家耳鼻咽喉头颈外科(OHNS)服务的因素有很多,包括基础设施不足、学术职位有限、不利的医院研究政策以及对性别和手术的传统误解等等。虽然性别不平等现象在全球范围内都存在,但在中低收入国家尤其是非洲尤为明显:我们利用PubMed、Embase和谷歌学术对2017年1月1日至2024年1月10日期间美国/加拿大和非洲的相关手稿进行了比较叙述性文献综述。195篇相关文章来自美国/加拿大,只有5篇来自非洲,只有1篇手稿与OHNS相关。经审查的文章报告称,在医学培训、作者身份和职业晋升方面存在性别差异。我们强调了解决其中一些差异的可能办法,以促进非洲乃至全世界的 OHNS 工作队伍性别更加多元化。这些研究将突出强调包容性政策、结构化和可获得的指导计划的必要性;通过这些计划,可以突出强调和解决这些差距。从长远来看,这将确保低收入国家和地区 OHNS 护理的可持续性。
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引用次数: 0
Paediatric voice disorder: who to refer and how to assess? A summary of recent literature. 儿科嗓音障碍:转诊对象和评估方法?最新文献综述。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-04 DOI: 10.1097/MOO.0000000000000970
Wendy Cohen, David M Wynne

Purpose of review: The purpose of this review is to update the reader with recent advances and current opinion on the assessment and management of paediatric voice disorders.

Recent findings: Access to advanced multidisciplinary paediatric voice clinics has increased over the last decade. Often the assessment is combined between speech therapy/pathology and ENT surgery. Vocal fold nodules remain the most prevalent diagnosis at a paediatric voice clinic, but significant diseases will also present, for example laryngeal papilloma. Recently, more consideration of the psychosocial aspect of voice disorders and evaluation of auditory processing disorders have shown how these can have a negative impact. There also appears to be a lack of parental and teacher awareness of paediatric voice disorders and their significance.

Summary: We would recommend multiparametric assessment and analysis of all children with a voice disorder. Most paediatric voice conditions will respond to skilled voice therapy. However, the exact techniques and dosage requires further evaluation and research. Paediatric voice conditions are common and should not be dismissed, as they may represent significant disease, for example papilloma, vagal palsy or have a significant psychosocial impact on the child.

综述目的:本综述旨在向读者介绍儿科嗓音疾病评估和管理的最新进展和当前观点:最近的发现:在过去十年中,先进的多学科儿科嗓音诊所越来越多。通常情况下,语言治疗/病理学和耳鼻喉科手术会联合进行评估。声带小结仍是儿科嗓音门诊最常见的诊断,但也会出现一些重大疾病,如喉乳头状瘤。最近,对嗓音疾病的社会心理方面的更多考虑以及对听觉处理障碍的评估表明,这些都会产生负面影响。此外,家长和教师似乎对儿科嗓音疾病及其重要性缺乏认识。总结:我们建议对所有患有嗓音疾病的儿童进行多参数评估和分析。大多数儿科嗓音疾病会对熟练的嗓音治疗产生反应。但是,具体的技术和剂量还需要进一步的评估和研究。儿科嗓音疾病很常见,不应被忽视,因为它们可能代表重大疾病,如乳头状瘤、迷走神经麻痹,或对儿童产生重大的社会心理影响。
{"title":"Paediatric voice disorder: who to refer and how to assess? A summary of recent literature.","authors":"Wendy Cohen, David M Wynne","doi":"10.1097/MOO.0000000000000970","DOIUrl":"10.1097/MOO.0000000000000970","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to update the reader with recent advances and current opinion on the assessment and management of paediatric voice disorders.</p><p><strong>Recent findings: </strong>Access to advanced multidisciplinary paediatric voice clinics has increased over the last decade. Often the assessment is combined between speech therapy/pathology and ENT surgery. Vocal fold nodules remain the most prevalent diagnosis at a paediatric voice clinic, but significant diseases will also present, for example laryngeal papilloma. Recently, more consideration of the psychosocial aspect of voice disorders and evaluation of auditory processing disorders have shown how these can have a negative impact. There also appears to be a lack of parental and teacher awareness of paediatric voice disorders and their significance.</p><p><strong>Summary: </strong>We would recommend multiparametric assessment and analysis of all children with a voice disorder. Most paediatric voice conditions will respond to skilled voice therapy. However, the exact techniques and dosage requires further evaluation and research. Paediatric voice conditions are common and should not be dismissed, as they may represent significant disease, for example papilloma, vagal palsy or have a significant psychosocial impact on the child.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319946","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
Current approaches to gender-affirming vocal care. 目前的性别确认声乐护理方法。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-23 DOI: 10.1097/MOO.0000000000000967
Sarah McBrinn, Christella Antoni, Chadwan Al Yaghchi

Purpose of review: This review addresses the challenges faced by transgender women in achieving congruence between gender identity and voice characteristics and emphasizes the importance of a multidisciplinary approach involving therapeutic and surgical interventions.

Recent findings: Recent literature on gender-affirming vocal care emphasizes key themes such as assessment, voice feminization therapy, and various surgical techniques, including glottoplasty and its modifications. Recent publications focused on outcomes, duration, and impact on vocal quality and scrutinized complications associated with surgical interventions.

Summary: Most publications in the last 18 months advocate for the integration of voice therapy and surgery for optimal outcomes. Utilising a combined approach is significantly more effective in terms of fundamental frequency gain compared to therapy alone. Modified Wendler's glottoplasty remains the preferred and most reliable surgical intervention. However, surgery is not without its complications and vocal trade-offs, in particular, its impact on vocal projection and the risk of long-term dysphonia. Postsurgery rehabilitation improves long-term outcomes. Recent publications on alternative surgical approaches, namely laser reduction glottoplasty and feminization laryngoplasty, show promise but the results are more difficult to generalise.

Future direction: Prospective multicentre studies with standardized protocols are needed to establish best evidence-based practices.

综述的目的:这篇综述探讨了变性女性在实现性别认同与嗓音特征一致性方面所面临的挑战,并强调了涉及治疗和手术干预的多学科方法的重要性:近期有关性别确认嗓音护理的文献强调了评估、嗓音女性化治疗和各种手术技术(包括声门成形术及其改良)等关键主题。摘要:在过去的18个月中,大多数出版物都主张将嗓音治疗与手术相结合,以获得最佳效果。就基频增益而言,综合疗法比单独疗法更有效。改良温德勒声门成形术仍是首选和最可靠的手术干预方法。然而,手术并非没有并发症和发声权衡,尤其是对声带投影的影响和长期发音障碍的风险。手术后康复治疗可改善长期疗效。最近发表的关于其他手术方法的文章,即激光缩窄声门成形术和女性化喉成形术,显示出了良好的前景,但其结果较难推广:未来方向:需要开展具有标准化方案的前瞻性多中心研究,以确立最佳循证实践。
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引用次数: 0
Swallowing after total laryngectomy surgery: where are we after 150 years? 全喉切除手术后的吞咽:150 年后的我们在哪里?
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-06-01 Epub Date: 2024-03-13 DOI: 10.1097/MOO.0000000000000965
Laura M O'Connor, Julia C F Maclean
{"title":"Swallowing after total laryngectomy surgery: where are we after 150 years?","authors":"Laura M O'Connor, Julia C F Maclean","doi":"10.1097/MOO.0000000000000965","DOIUrl":"10.1097/MOO.0000000000000965","url":null,"abstract":"","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868262","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
Sustainable equipment donation in otolaryngology in low-resource settings. 低资源环境下耳鼻喉科的可持续设备捐赠。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-18 DOI: 10.1097/MOO.0000000000000972
Catherine de Cates, Aurélien M Guéroult, Gan-Erdene Narantsolmon

Purpose of review: The purpose of this review is to examine current practices in surgical equipment donation to lower- and middle-income countries (LMICs) with a particular focus on otolaryngology-head and neck surgery (OHNS). This is designed as a pragmatic review to guide potential donor communities to implement sustainable OHNS equipment donation in LMICs.

Recent findings: LMICs are increasingly reliant on international equipment donation. In terms of OHNS services, global OHNS have compiled a list of essential equipment for baseline care in LMICs. Especially in terms of audiology, OHNS equipment donation has the potential to have a significant impact on populational health. However, there is a scarcity of research on donated equipment in OHNS. A suggested blueprint for sustainable equipment donation follows these steps: establish partnerships, assess needs, source equipment, and follow-up and evaluate the intervention. Key further considerations for sustainability include remanufacturing and repurposing methods, maintenance, and contextual understanding.

Summary: Sustainable equipment donation in otolaryngology is an important part of global health equity and healthcare delivery in low-resource settings. Despite the good intentions behind medical equipment donations, there are many challenges; donors and recipients should engage in collaborative, needs-based planning processes that result in long-term sustainability, local capacity building, and community participation.

综述目的:本综述旨在研究向中低收入国家(LMICs)捐赠手术设备的现行做法,尤其侧重于耳鼻咽喉头颈外科(OHNS)。本文旨在通过务实的综述,指导潜在的捐赠团体在中低收入国家实施可持续的耳鼻咽喉头颈外科设备捐赠:最近的研究结果:低收入国家越来越依赖于国际设备捐赠。就听力保健服务而言,全球听力保健服务机构已编制了一份清单,列出了低收入国家基线护理所需的基本设备。特别是在听力方面,OHNS 设备捐赠有可能对人口健康产生重大影响。然而,有关 OHNS 捐赠设备的研究却很少。建议的可持续设备捐赠蓝图遵循以下步骤:建立伙伴关系、评估需求、寻找设备、跟进和评估干预措施。摘要:耳鼻喉科的可持续设备捐赠是全球卫生公平和在低资源环境中提供医疗服务的重要组成部分。尽管医疗设备捐赠的初衷是好的,但仍存在许多挑战;捐赠者和受赠者应共同参与以需求为基础的规划过程,从而实现长期可持续性、当地能力建设和社区参与。
{"title":"Sustainable equipment donation in otolaryngology in low-resource settings.","authors":"Catherine de Cates, Aurélien M Guéroult, Gan-Erdene Narantsolmon","doi":"10.1097/MOO.0000000000000972","DOIUrl":"10.1097/MOO.0000000000000972","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to examine current practices in surgical equipment donation to lower- and middle-income countries (LMICs) with a particular focus on otolaryngology-head and neck surgery (OHNS). This is designed as a pragmatic review to guide potential donor communities to implement sustainable OHNS equipment donation in LMICs.</p><p><strong>Recent findings: </strong>LMICs are increasingly reliant on international equipment donation. In terms of OHNS services, global OHNS have compiled a list of essential equipment for baseline care in LMICs. Especially in terms of audiology, OHNS equipment donation has the potential to have a significant impact on populational health. However, there is a scarcity of research on donated equipment in OHNS. A suggested blueprint for sustainable equipment donation follows these steps: establish partnerships, assess needs, source equipment, and follow-up and evaluate the intervention. Key further considerations for sustainability include remanufacturing and repurposing methods, maintenance, and contextual understanding.</p><p><strong>Summary: </strong>Sustainable equipment donation in otolaryngology is an important part of global health equity and healthcare delivery in low-resource settings. Despite the good intentions behind medical equipment donations, there are many challenges; donors and recipients should engage in collaborative, needs-based planning processes that result in long-term sustainability, local capacity building, and community participation.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319947","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
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Current Opinion in Otolaryngology & Head and Neck Surgery
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