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Infectious disease for the rhinologist. 鼻科医生的传染病
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2023-11-22 DOI: 10.1097/MOO.0000000000000947
Lu Hui Png, Dorothy Hui Lin Ng, Neville Wei Yang Teo

Purpose of review: The purpose of this review is to summarize the recent literature relating to viral, fungal and bacterial infections and their interactions within the sinonasal tract in the past 18 months.

Recent findings: Coronavirus disease 2019 (COVID-19)-associated olfactory dysfunction (OD) is variant dependent. Magnetic resonance imaging studies have found greater olfactory cleft opacification and higher olfactory bulb volume in post-COVID-19 OD. Olfactory training remains the mainstay of treatment, while platelet-rich plasma injections and ultramicronized palmitoylethanolamide and luteolin combination oral supplementation have shown early promise.Consensus statements on paranasal sinus fungal balls and acute invasive fungal sinusitis have been released.Studies on the nasal microbiome have reported Staphylococcus and Corynebacterium as the most abundant genera, with higher levels of Staphylococcus and Corynebacterium being found in patients with chronic rhinosinusitis (CRS) and healthy individuals respectively. However, there is conflicting evidence on the significance of biodiversity of the nasal microbiome found in CRS versus healthy patients.

Summary: While the peak of the COVID-19 pandemic is behind us, its sequelae continue to pose treatment challenges. Further studies in OD have implications in managing the condition, beyond those afflicted post-COVID-19 infection. Similarly, more research is needed in studying the nasal microbiome and its implications in the development and treatment of CRS.

综述目的:本综述的目的是总结近18个月来有关鼻道内病毒、真菌和细菌感染及其相互作用的最新文献。最新发现:2019冠状病毒病(COVID-19)相关的嗅觉功能障碍(OD)是变异依赖的。磁共振成像研究发现,covid -19 OD后的嗅裂混浊更大,嗅球体积更大。嗅觉训练仍然是治疗的主要方法,而富血小板血浆注射和超微化棕榈酰乙醇酰胺和木犀草素联合口服补充已经显示出早期的希望。关于副鼻窦真菌球和急性侵袭性真菌鼻窦炎的共识声明已经发布。在鼻腔微生物组的研究中,葡萄球菌和棒状杆菌是最丰富的属,在慢性鼻窦炎(CRS)患者和健康个体中分别发现较高水平的葡萄球菌和棒状杆菌。然而,关于CRS患者与健康患者鼻腔微生物组生物多样性的重要性,存在相互矛盾的证据。总结:虽然COVID-19大流行的高峰已经过去,但其后遗症继续给治疗带来挑战。在covid -19感染后,对OD的进一步研究对控制病情具有重要意义。同样,需要更多的研究来研究鼻腔微生物组及其在CRS的发展和治疗中的意义。
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引用次数: 0
Pulmonology for the rhinologist. 鼻科医生的肺科。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2023-11-15 DOI: 10.1097/MOO.0000000000000944
Raewyn G Campbell, Titus Auyeung, Gregory P Katsoulotos

Purpose of review: The upper and lower airways are inter-related despite serving different functions and can no longer be considered separately. Rhinologists are becoming increasingly aware of the role the lower airway plays in optimizing outcomes for their patients. This review highlights recent developments in pulmonology that impact rhinologic conditions.

Recent findings: The unified airway concept now supports the multidisciplinary management of respiratory and rhinologic pathologies. Biomarkers, biologics and the concept of treatable traits have permitted the development of personalized and precise treatment of the entire respiratory tract. The concept of corticosteroid stewardship, the introduction of steroid sparing agents for the treatment of respiratory diseases and the development of biomarkers, now forces us to be more considerate and precise with oral corticosteroid (OCS) prescribing and to consider reduction regimens. Finally, current research on climate change and vaping will allow us to better educate and prepare our patients to improve adherence and avoid exacerbations to maintain optimal global respiratory health.

Summary: The inter-relatedness of the upper and lower airway has encouraged a multidisciplinary focus in respiratory medicine. More research is required to improve the precision respiratory medicine model, particularly in the realm of biomarkers and endotyping. These developments must also consider the impact of climate change, pollution and toxins for us to provide optimum care for our patients.

综述目的:尽管上、下气道功能不同,但它们是相互关联的,不能再分开考虑。鼻科医生越来越意识到下气道在优化患者预后方面的作用。这篇综述强调了影响鼻科疾病的肺部学最新进展。最新发现:统一气道的概念现在支持呼吸和鼻病理的多学科管理。生物标志物、生物制剂和可治疗特征的概念使得整个呼吸道的个性化和精确治疗的发展成为可能。皮质类固醇管理的概念、用于治疗呼吸系统疾病的类固醇保留剂的引入和生物标志物的发展,现在迫使我们更加考虑和精确地使用口服皮质类固醇(OCS)处方,并考虑减量方案。最后,目前关于气候变化和电子烟的研究将使我们能够更好地教育和准备我们的患者,以提高依从性,避免病情恶化,以保持最佳的全球呼吸健康。摘要:上、下气道的相互关系促使呼吸医学多学科关注。需要更多的研究来改善精确的呼吸医学模型,特别是在生物标志物和内皮分型领域。这些发展还必须考虑气候变化、污染和毒素的影响,以便我们为患者提供最佳护理。
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引用次数: 0
Radiation oncology for the rhinologist. 鼻科医生的放射肿瘤学。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2023-11-30 DOI: 10.1097/MOO.0000000000000942
Helena Levyn, Fan Yang, Nancy Y Lee

Purpose of review: This comprehensive review explores evolving treatment strategies for sinonasal and nasopharyngeal malignancies. It analyzes the role of adjuvant radiotherapy, the potential of intensity-modulated proton therapy (IMPT), and the relevance of de-escalation strategies nasopharyngeal carcinoma (NPC). Additionally, it discusses hyperfractionation in re-irradiation in NPC.

Recent findings: Adjuvant radiotherapy remains pivotal for sinonasal tumors, improving locoregional control and survival, notably in squamous cell carcinomas, adenocarcinomas, and adenoid cystic carcinomas. IMPT promises enhanced outcomes by sparing healthy tissues, potentially improving patients' quality of life. For select stage II/T3N0 NPC, radiotherapy alone offers comparable outcomes to concurrent chemoradiotherapy, with fewer adverse events and improved quality of life. Selective neck irradiation in NPC patients with uninvolved necks maintains oncologic outcomes while reducing late toxicity. Hyperfractionation in re-irradiation shows promise in lowering late toxicities and improving overall survival, particularly in undifferentiated sinonasal carcinomas.

Summary: This review underscores the significance of adjuvant radiotherapy and the potential of advanced radiation techniques in optimizing sinonasal and nasopharyngeal malignancy outcomes. It emphasizes evolving de-escalation methods and individualized, evidence-based approaches. Future research will further refine strategies for these challenging malignancies.

综述的目的:这篇综合综述探讨了鼻窦和鼻咽恶性肿瘤不断发展的治疗策略。它分析了辅助放疗的作用、调强质子治疗(IMPT)的潜力以及去升级策略鼻咽癌(NPC)的相关性。此外,报告还讨论了鼻咽癌再照射中的超分割治疗:最近的研究结果:辅助放疗对鼻窦肿瘤仍然至关重要,可改善局部控制和生存率,尤其是对鳞状细胞癌、腺癌和腺样囊性癌。IMPT 通过保留健康组织,有望提高疗效,从而改善患者的生活质量。对于选择性 II/T3N0 期鼻咽癌,单纯放疗的疗效与同期化放疗相当,不良反应更少,生活质量更高。对颈部未受累的鼻咽癌患者进行选择性颈部照射,既能保持肿瘤治疗效果,又能减少后期毒性。再照射中的超分割治疗有望降低晚期毒性并提高总生存率,尤其是在未分化鼻窦癌中。 摘要:这篇综述强调了辅助放疗的重要性以及先进放射技术在优化鼻窦和鼻咽恶性肿瘤疗效方面的潜力。它强调了不断发展的降级方法和个体化的循证方法。未来的研究将进一步完善这些具有挑战性的恶性肿瘤的治疗策略。
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引用次数: 0
Neurosurgery for the rhinologist. 鼻科医生的神经外科。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2023-12-14 DOI: 10.1097/MOO.0000000000000950
Mariagrazia Nizzola, Luciano C P C Leonel, Maria Peris-Celda

Purpose of review: The purpose of this review is to provide a comprehensive anatomical appraisal of the neurosurgical anatomy exposed through the endonasal and paranasal sinuses routes, focusing on the most common expanded endonasal approaches (EEAs) as well as recent advances in this surgical field.

Recent findings: The EEAs are redefining the management of skull base pathology. Neurovascular structures previously considered a limitation, can be now approached through these surgical corridors. Advances in this field include the development of new surgical techniques and routes that allow better visualization and access to pathologies located in the ventral skull base. Understanding the surgical anatomy related to EEAs is essential not only for neurosurgeons but also for rhinologists.

Summary: Knowledge of the surgical anatomy of the most common EEAs that utilize paranasal sinuses as a surgical corridor enables more effective management of complex skull base pathologies. Comprehensive anatomical knowledge of these corridors and the surrounding neurovascular structures is crucial to maximize benefits of EEAs and improve outcomes.

综述目的:本综述旨在对通过鼻内窦和鼻旁窦途径暴露的神经外科解剖进行全面的解剖学评估,重点关注最常见的鼻内窦扩大入路(EEA)以及该手术领域的最新进展:最新研究结果:EEA 正在重新定义颅底病理学的治疗方法。神经血管结构以前被认为是一种限制,现在可以通过这些手术通道进行治疗。这一领域的进展包括开发了新的手术技术和路径,使位于腹侧颅底的病变得到更好的观察和治疗。摘要:了解利用鼻旁窦作为手术走廊的最常见 EEA 的手术解剖学知识,可以更有效地治疗复杂的颅底病变。全面掌握这些走廊和周围神经血管结构的解剖知识,对于最大限度地发挥 EEA 的优势和改善疗效至关重要。
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引用次数: 0
Ophthalmology and oculoplastics for the rhinologist. 鼻科医生的眼科和眼部整形。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2023-12-06 DOI: 10.1097/MOO.0000000000000943
S Tonya Stefko, Anna K Terrarosa

Purpose of review: As the management of ophthalmic and sinus disease advances, it is important to stay abreast of all current management options. This involves knowledge of adjacent anatomy and disease processes, and collaboration between multiple specialties. The authors provide a review of relevant ophthalmic and oculoplastic topics for the rhinologist.

Recent findings: The scope and surgical skills of oculoplastic and rhinologist specialists have grown in conjunction with medical and technological advancements. Familiarity with the presentations of sinus disease in the orbit can decrease the time to disease recognition, and improve morbidity and mortality. Collaborative approaches provide improved access to areas of interest throughout the orbit and sinuses. Multiportal, transorbital, and endoscopic techniques can improve patient morbidity and mortality compared to conventional open approaches. Familiarity with all medical and surgical treatment options can help tailor treatments to patients' needs.

Summary: Multidisciplinary approaches to sinus and orbit disease and the incorporation of new surgical technologies can improve patient options and outcomes.

回顾的目的:随着眼科和鼻窦疾病治疗的不断发展,掌握当前所有的治疗方案非常重要。这涉及到邻近解剖和疾病过程的知识,以及多个专科之间的合作。作者为鼻科医生提供了相关眼科和眼整形专题的综述:最近的研究结果:随着医学和技术的进步,眼部整形和鼻科专家的工作范围和手术技能也在不断增长。熟悉眼眶鼻窦疾病的表现形式可以缩短疾病的识别时间,提高发病率和死亡率。通过协作方法可以更好地进入整个眼眶和鼻窦的相关区域。与传统的开放式方法相比,多孔、经眶和内窥镜技术可提高患者的发病率和死亡率。小结:多学科方法治疗鼻窦和眼眶疾病以及采用新的手术技术可以改善患者的选择和治疗效果。
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引用次数: 0
Editorial introductions. 编辑介绍。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-02-01 Epub Date: 2024-01-04 DOI: 10.1097/MOO.0000000000000946
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引用次数: 0
Update on the evaluation and management of dysphagia in sporadic inclusion body myositis. 散发性包涵体肌炎吞咽困难的评估和治疗进展。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-01 DOI: 10.1097/MOO.0000000000000922
Kendrea L Focht Garand, Georgia A Malandraki, Mazen M Dimachkie

Purpose of review: Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably understudied. The purpose of this review is to summarize current evidence related to the evaluation and management of dysphagia in IBM. We highlight a patient case involving a multidisciplinary management approach, and we encourage continued exploration of exercises for delaying progression and improving impairments in patients with IBM and dysphagia.

Recent findings: Recent investigations confirm that dysphagia in IBM is a debilitating and complex symptom that warrants timely evaluation and management. Further, they highlight the lack of validation of standardized swallowing-related metrics specifically for IBM and the limited evidence supporting a consensus of management approaches. Small scale research and clinical anecdotal data support a multidisciplinary and multipronged patient-centered approach, including rehabilitative exercise protocols, for dysphagia management in IBM.

Summary: A paucity exists in the literature to effectively guide clinical decision-making for patients with IBM and dysphagia. Given this, it is our belief that a careful multidisciplinary and multipronged patient-centered approach is critical for dysphagia management in IBM. Prospective, longitudinal research on the underlying mechanisms of swallowing dysfunction using advanced and validated swallowing-related outcome measures is urgently needed.

综述目的:吞咽困难是散发性包涵体肌炎(IBM)的常见症状,影响疾病轨迹和患者生活质量。尽管如此,它的研究还是相当不足。本综述的目的是总结目前与IBM吞咽困难评估和管理相关的证据。我们强调了一个涉及多学科管理方法的患者案例,我们鼓励继续探索运动,以延缓IBM和吞咽困难患者的进展并改善其损伤。最近的发现:最近的调查证实,IBM的吞咽困难是一种使人衰弱的复杂症状,需要及时评估和治疗。此外,他们强调了缺乏专门针对IBM的标准化吞咽相关指标的验证,以及支持管理方法共识的证据有限。小规模研究和临床轶事数据支持IBM以患者为中心的多学科和多管齐下的方法,包括康复锻炼方案,用于吞咽困难管理。摘要:文献中缺乏有效指导IBM和吞咽困难患者临床决策的内容。考虑到这一点,我们相信,在IBM,一种谨慎的多学科和多管齐下的以患者为中心的方法对于吞咽困难的管理至关重要。迫切需要使用先进且经验证的吞咽相关结果指标对吞咽功能障碍的潜在机制进行前瞻性、纵向研究。
{"title":"Update on the evaluation and management of dysphagia in sporadic inclusion body myositis.","authors":"Kendrea L Focht Garand,&nbsp;Georgia A Malandraki,&nbsp;Mazen M Dimachkie","doi":"10.1097/MOO.0000000000000922","DOIUrl":"10.1097/MOO.0000000000000922","url":null,"abstract":"<p><strong>Purpose of review: </strong>Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably understudied. The purpose of this review is to summarize current evidence related to the evaluation and management of dysphagia in IBM. We highlight a patient case involving a multidisciplinary management approach, and we encourage continued exploration of exercises for delaying progression and improving impairments in patients with IBM and dysphagia.</p><p><strong>Recent findings: </strong>Recent investigations confirm that dysphagia in IBM is a debilitating and complex symptom that warrants timely evaluation and management. Further, they highlight the lack of validation of standardized swallowing-related metrics specifically for IBM and the limited evidence supporting a consensus of management approaches. Small scale research and clinical anecdotal data support a multidisciplinary and multipronged patient-centered approach, including rehabilitative exercise protocols, for dysphagia management in IBM.</p><p><strong>Summary: </strong>A paucity exists in the literature to effectively guide clinical decision-making for patients with IBM and dysphagia. Given this, it is our belief that a careful multidisciplinary and multipronged patient-centered approach is critical for dysphagia management in IBM. Prospective, longitudinal research on the underlying mechanisms of swallowing dysfunction using advanced and validated swallowing-related outcome measures is urgently needed.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"362-367"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184567","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
Malnutrition in aged care: interplay between dysphagia and diet. 老年护理中的营养不良:吞咽困难和饮食之间的相互作用。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2023-12-01 Epub Date: 2023-07-13 DOI: 10.1097/MOO.0000000000000911
Xiaojing Sharon Wu, Anna Miles, Andrea Braakhuis

Purpose of review: This review aims to deliver expert insights on the current advances and challenges in managing malnutrition in aged care settings, with a specific emphasis on the interaction between dysphagia and diet.

Recent findings: Several reviews identify the high prevalence of dysphagia in aged care facilities and highlight the correlation between dysphagia and malnutrition. Recent studies underscore the importance of nutrition and cancer screening and assessment, yet highlight the lack of consensus on the definitive tools to be used. There is a growth in employing innovative implementations for enhancing swallowing function and optimizing texture-modified foods.

Summary: Early identification and strategic interventions are vital for managing malnutrition and dysphagia in aged care facilities, as these conditions are widespread and lead to a higher risk of complications. Although nutritional strategies have shown potential in enhancing oral intake for residents requiring texture-modified foods, lack of investigation on functional outcomes and long-term impact have been highlighted, emphasizing the need for continued research and development of effective assessment tools and targeted interventions to optimize the care for this at-risk group.

综述目的:本综述旨在就老年护理环境中管理营养不良的当前进展和挑战提供专家见解,特别强调吞咽困难和饮食之间的相互作用。最近的研究结果:几篇综述确定了老年护理机构中吞咽困难的高患病率,并强调了吞咽困难与营养不良之间的相关性。最近的研究强调了营养和癌症筛查和评估的重要性,但也强调了对使用的最终工具缺乏共识。采用创新的实施方式来增强吞咽功能和优化质地改良食品的情况正在增加。总结:早期识别和战略干预对于管理老年护理机构的营养不良和吞咽困难至关重要,因为这些情况普遍存在,导致并发症的风险更高。尽管营养策略在增加需要质地改良食品的居民的口腔摄入方面显示出了潜力,但人们强调,缺乏对功能结果和长期影响的调查,强调需要继续研究和开发有效的评估工具和有针对性的干预措施,以优化对这一风险群体的护理。
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引用次数: 0
Emerging findings for the assessment and treatment of pediatric deep neck abscesses. 儿科深颈部脓肿评估和治疗的新发现。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI: 10.1097/MOO.0000000000000937
Paul Bryan Hankey, Meghan Tracy, Jill M Arganbright
Purpose of review The purpose of this review is to summarize new literature regarding the description, diagnosis, and treatment of pediatric deep neck abscesses. Recent findings Providers should include multi-inflammatory syndrome in children (MIS-C) in a differential diagnosis in children suspected of having a retropharyngeal abscess. MRI may guide the proper management of children with deep neck abscesses by more accurately detecting free fluid compared to computed tomography imaging. Factors that may predict the need for surgical management include elevations in white blood cell counts and abscess size more than 3 cm. However, future investigation is necessary to establish consistent guidelines. Medical management is effective in many children, with a new study indicating success using a combination of cefotaxime and rifampicin. Summary Anatomical and age-related risk factors predispose children to the development of deep neck abscesses. Findings from recent studies may aid providers in making an accurate diagnosis and providing proper medical or surgical management of children with these infections.
综述的目的:本综述的目的是总结关于儿童深颈脓肿的描述、诊断和治疗的新文献。最近的发现:提供者应将儿童多炎症综合征(MIS-C)纳入疑似咽后脓肿儿童的鉴别诊断中。与计算机断层扫描成像相比,MRI可以通过更准确地检测游离液体来指导儿童深颈脓肿的正确治疗。可能预测需要手术治疗的因素包括白细胞计数升高和脓肿大小超过3 cm。然而,为了建立一致的指导方针,未来的调查是必要的。医疗管理对许多儿童是有效的,一项新的研究表明,使用头孢噻肟和利福平的组合是成功的。摘要:解剖学和年龄相关的危险因素使儿童易患颈深脓肿。最近的研究结果可能有助于提供者对这些感染的儿童做出准确的诊断,并提供适当的医疗或外科治疗。
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引用次数: 0
Editorial introductions. 编辑介绍。
IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1097/MOO.0000000000000939
{"title":"Editorial introductions.","authors":"","doi":"10.1097/MOO.0000000000000939","DOIUrl":"https://doi.org/10.1097/MOO.0000000000000939","url":null,"abstract":"","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":"31 6","pages":"v-vi"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429360","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
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