Pub Date : 2023-12-01Epub Date: 2023-10-09DOI: 10.1097/MOO.0000000000000935
Ethan Bassett
Purpose of review: Tonsillectomy is one of the most common surgical procedures performed on children in the United States. Since 2002, the intracapsular technique has been studied as a safer and less painful alternative to total tonsillectomy. Concerns have been raised, however, as to the potential for regrowth and long-term outcomes regarding this technique.
Recent findings: Studies support the use of intracapsular tonsillectomy in the management of sleep disordered breathing, including in syndromic populations, as well as for tonsillitis. In addition, safety profiles continue to be improved over that of extracapsular dissection. While the incidence of regrowth ranges depending on the study and duration of follow up, it remains acceptably low. The most consistent independent risk factor for revision surgery includes young age.
Summary: While total tonsillectomy is more thoroughly studied historically, an important absence in the literature is a definitive superiority over the intracapsular technique. With continued high-level studies, as well as additional examination of long-term outcomes, we should continue to see greater acceptance of intracapsular tonsillectomy as a standard of practice in a vulnerable population.
{"title":"Intracapsular tonsillectomy: setting a new standard.","authors":"Ethan Bassett","doi":"10.1097/MOO.0000000000000935","DOIUrl":"10.1097/MOO.0000000000000935","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tonsillectomy is one of the most common surgical procedures performed on children in the United States. Since 2002, the intracapsular technique has been studied as a safer and less painful alternative to total tonsillectomy. Concerns have been raised, however, as to the potential for regrowth and long-term outcomes regarding this technique.</p><p><strong>Recent findings: </strong>Studies support the use of intracapsular tonsillectomy in the management of sleep disordered breathing, including in syndromic populations, as well as for tonsillitis. In addition, safety profiles continue to be improved over that of extracapsular dissection. While the incidence of regrowth ranges depending on the study and duration of follow up, it remains acceptably low. The most consistent independent risk factor for revision surgery includes young age.</p><p><strong>Summary: </strong>While total tonsillectomy is more thoroughly studied historically, an important absence in the literature is a definitive superiority over the intracapsular technique. With continued high-level studies, as well as additional examination of long-term outcomes, we should continue to see greater acceptance of intracapsular tonsillectomy as a standard of practice in a vulnerable population.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220730","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}
Pub Date : 2023-12-01Epub Date: 2023-10-09DOI: 10.1097/MOO.0000000000000933
Lourdes Quintanilla-Dieck
Purpose of review: Graves' disease (GD) constitutes a significant proportion of thyroid disorders seen during childhood. Several specialties may be closely involved in the management of pediatric patients with GD and emerging research in each field contributes to variations in the approach over time. Here we review the recent literature on the management of the disease, with the hope that this can be a valuable resource for treating specialists who need to be continuously updated on new data obtained in relevant fields.
Recent findings: Genetic, postinfectious and environmental factors may play a role in the immunological pathophysiology of GD. Research performed during the COVID-19 pandemic supports that viral-induced immune dysregulation may be a possible trigger for the disease. The various current treatment options all have positive and negative factors to consider. Antithyroidal drug therapy (ATD) is generally recommended as the initial treatment, although remission rates are only 20-30% at 2 years and 75% at 9 years. Unfortunately, about half of patients will relapse within 1 year of discontinuing therapy. Radioactive iodine therapy (RAI) is an effective treatment option and can be considered in certain pediatric patients. There continues to be no definitive evidence that the doses used for GD lead to a higher risk of cancer. Surgical treatment via thyroidectomy is effective and safe when performed by a high-volume surgeon. Recent studies show improvement in quality-of-life after surgery in adolescents and young adults. Future medical treatment options for GD currently being studied include antigen-specific immunotherapy and monoclonal antibodies.
Summary: Although the future holds promising new therapeutic options for autoimmune diseases including GD, the current choices continue to be ATD, usually first-line, and definitive treatments including RAI and surgery. While all three offer the possibility of remission or cure, drug therapy and RAI have a possibility of relapse. Risks of each approach should be broached in detail with patients and their families, and the nuances of treating this disease specifically in children should be familiar to all treating providers.
{"title":"The management of pediatric Graves' disease.","authors":"Lourdes Quintanilla-Dieck","doi":"10.1097/MOO.0000000000000933","DOIUrl":"10.1097/MOO.0000000000000933","url":null,"abstract":"<p><strong>Purpose of review: </strong>Graves' disease (GD) constitutes a significant proportion of thyroid disorders seen during childhood. Several specialties may be closely involved in the management of pediatric patients with GD and emerging research in each field contributes to variations in the approach over time. Here we review the recent literature on the management of the disease, with the hope that this can be a valuable resource for treating specialists who need to be continuously updated on new data obtained in relevant fields.</p><p><strong>Recent findings: </strong>Genetic, postinfectious and environmental factors may play a role in the immunological pathophysiology of GD. Research performed during the COVID-19 pandemic supports that viral-induced immune dysregulation may be a possible trigger for the disease. The various current treatment options all have positive and negative factors to consider. Antithyroidal drug therapy (ATD) is generally recommended as the initial treatment, although remission rates are only 20-30% at 2 years and 75% at 9 years. Unfortunately, about half of patients will relapse within 1 year of discontinuing therapy. Radioactive iodine therapy (RAI) is an effective treatment option and can be considered in certain pediatric patients. There continues to be no definitive evidence that the doses used for GD lead to a higher risk of cancer. Surgical treatment via thyroidectomy is effective and safe when performed by a high-volume surgeon. Recent studies show improvement in quality-of-life after surgery in adolescents and young adults. Future medical treatment options for GD currently being studied include antigen-specific immunotherapy and monoclonal antibodies.</p><p><strong>Summary: </strong>Although the future holds promising new therapeutic options for autoimmune diseases including GD, the current choices continue to be ATD, usually first-line, and definitive treatments including RAI and surgery. While all three offer the possibility of remission or cure, drug therapy and RAI have a possibility of relapse. Risks of each approach should be broached in detail with patients and their families, and the nuances of treating this disease specifically in children should be familiar to all treating providers.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220734","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}
Pub Date : 2023-12-01Epub Date: 2023-09-26DOI: 10.1097/MOO.0000000000000929
Tiffany Raynor, Joshua Bedwell
Purpose of review: Pediatric decannulation failure can be associated with large morbidity and mortality, yet there are no published evidence-based guidelines for pediatric tracheostomy decannulation. Tracheostomy is frequently performed in medically complex children in whom it can be difficult to predict when and how to safely decannulate.
Recent findings: Published studies regarding pediatric decannulation are limited to reviews and case series from single institutions, with varying populations, indications for tracheostomy, and institutional resources. This article will provide a review of published decannulation protocols over the past 10 years. Endoscopic airway evaluation is required to assess the patency of the airway and address any airway obstruction prior to decannulation. There is considerable variability in tracheostomy tube modification between published protocols, though the majority support a capping trial and downsizing of the tracheostomy tube to facilitate capping. Most protocols include overnight capping in a monitored setting prior to decannulation with observation ranging from 24 to 48 h after decannulation. There is debate regarding which patients should have capped polysomnography (PSG) prior to decannulation, as this exam is resource-intensive and may not be widely available. Persistent tracheocutaneous fistulae are common following decannulation. Excision of the fistula tract with healing by secondary intention has a lower reported operative time, overall complication rate, and postoperative length of stay.
Summary: Pediatric decannulation should occur in a stepwise process. The ideal decannulation protocol should be safe and expedient, without utilizing excessive healthcare resources. There may be variability in protocols based on patient population or institutional resources, but an explicitly described protocol within each institution is critical to consistent care and quality improvement over time. Further research is needed to identify selection criteria for who would most benefit from PSG prior to decannulation to guide allocation of this limited resource.
{"title":"Pediatric tracheostomy decannulation: what's the evidence?","authors":"Tiffany Raynor, Joshua Bedwell","doi":"10.1097/MOO.0000000000000929","DOIUrl":"10.1097/MOO.0000000000000929","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pediatric decannulation failure can be associated with large morbidity and mortality, yet there are no published evidence-based guidelines for pediatric tracheostomy decannulation. Tracheostomy is frequently performed in medically complex children in whom it can be difficult to predict when and how to safely decannulate.</p><p><strong>Recent findings: </strong>Published studies regarding pediatric decannulation are limited to reviews and case series from single institutions, with varying populations, indications for tracheostomy, and institutional resources. This article will provide a review of published decannulation protocols over the past 10 years. Endoscopic airway evaluation is required to assess the patency of the airway and address any airway obstruction prior to decannulation. There is considerable variability in tracheostomy tube modification between published protocols, though the majority support a capping trial and downsizing of the tracheostomy tube to facilitate capping. Most protocols include overnight capping in a monitored setting prior to decannulation with observation ranging from 24 to 48 h after decannulation. There is debate regarding which patients should have capped polysomnography (PSG) prior to decannulation, as this exam is resource-intensive and may not be widely available. Persistent tracheocutaneous fistulae are common following decannulation. Excision of the fistula tract with healing by secondary intention has a lower reported operative time, overall complication rate, and postoperative length of stay.</p><p><strong>Summary: </strong>Pediatric decannulation should occur in a stepwise process. The ideal decannulation protocol should be safe and expedient, without utilizing excessive healthcare resources. There may be variability in protocols based on patient population or institutional resources, but an explicitly described protocol within each institution is critical to consistent care and quality improvement over time. Further research is needed to identify selection criteria for who would most benefit from PSG prior to decannulation to guide allocation of this limited resource.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165557","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}
Pub Date : 2023-12-01Epub Date: 2023-10-11DOI: 10.1097/MOO.0000000000000925
Soren Gantt
Purpose of review: Congenital cytomegalovirus infection (cCMV) is a major cause of childhood hearing loss and neurodevelopmental delay. Early identification of cCMV allows for interventions that improve outcomes, particularly for cCMV-related hearing loss that develops in early childhood. Most cCMV is asymptomatic at birth and is rarely diagnosed without newborn screening. Therefore, various approaches to cCMV screening are increasingly being adopted.
Recent findings: Both universal screening (testing all newborns) and targeted screening (testing triggered by failed hearing screening) for cCMV appear valuable, feasible and cost-effective, though universal screening is predicted to have greatest potential overall benefits. CMV PCR testing of newborn oral swabs is sensitive and practical and is therefore widely used in targeted screening programs. In contrast, PCR using dried-blood spots (DBS) is less sensitive but was adopted by current universal cCMV screening initiatives because DBS are already collected from all newborns in high-income countries, which circumvents large-scale oral swab collection.
Summary: Targeted screening is widely recommended as standard of care, while universal screening is less common but is progressively considered as the optimal strategy for identification of children with cCMV. As with all screening programs, cCMV screening requires commitments to equitable and reliable testing, follow-up and services.
{"title":"Newborn cytomegalovirus screening: is this the new standard?","authors":"Soren Gantt","doi":"10.1097/MOO.0000000000000925","DOIUrl":"10.1097/MOO.0000000000000925","url":null,"abstract":"<p><strong>Purpose of review: </strong>Congenital cytomegalovirus infection (cCMV) is a major cause of childhood hearing loss and neurodevelopmental delay. Early identification of cCMV allows for interventions that improve outcomes, particularly for cCMV-related hearing loss that develops in early childhood. Most cCMV is asymptomatic at birth and is rarely diagnosed without newborn screening. Therefore, various approaches to cCMV screening are increasingly being adopted.</p><p><strong>Recent findings: </strong>Both universal screening (testing all newborns) and targeted screening (testing triggered by failed hearing screening) for cCMV appear valuable, feasible and cost-effective, though universal screening is predicted to have greatest potential overall benefits. CMV PCR testing of newborn oral swabs is sensitive and practical and is therefore widely used in targeted screening programs. In contrast, PCR using dried-blood spots (DBS) is less sensitive but was adopted by current universal cCMV screening initiatives because DBS are already collected from all newborns in high-income countries, which circumvents large-scale oral swab collection.</p><p><strong>Summary: </strong>Targeted screening is widely recommended as standard of care, while universal screening is less common but is progressively considered as the optimal strategy for identification of children with cCMV. As with all screening programs, cCMV screening requires commitments to equitable and reliable testing, follow-up and services.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220732","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}
Pub Date : 2023-12-01Epub Date: 2023-11-02DOI: 10.1097/MOO.0000000000000928
Julia Telischi, Eric Nisenbaum, Elizabeth Nicolli
Purpose of review: Currently, most patients with concurrent head and neck cancer (HNC) and carotid stenosis (CS) are treated disjointedly for their oncologic and vascular lesions. The purpose of this review is to evaluate literature exploring a novel approach to these cases that poses several advantages, in which carotid endarterectomy (CEA) is performed simultaneously with surgical resection of HNC.
Recent findings: Carotid stenosis is a common comorbidity of patients presenting with head and neck cancer as these pathologies have overlapping risk factors. Adjuvant oncologic therapy such as radiation therapy to the site of the lesion is known to increase development or progression of carotid stenosis. Performing simultaneous surgical management of CS and HNC decreases total procedures for the patient, provides a less challenging surgical field, and eliminates prioritization of treatment initiation for one pathology over the other. There has been limited reporting of simultaneous CEA with oncologic resection of HNC in the literature. However, of the 21 cases reviewed here, no perioperative strokes were reported with only one perioperative death from myocardial infarction.
Summary: Available literature supports that simultaneous CEA with oncologic resection of HNC is safe and may offer several advantages, although larger studies are required.
{"title":"Carotid endarterectomy for the management of carotid stenosis occurring concurrently with head and neck cancer.","authors":"Julia Telischi, Eric Nisenbaum, Elizabeth Nicolli","doi":"10.1097/MOO.0000000000000928","DOIUrl":"https://doi.org/10.1097/MOO.0000000000000928","url":null,"abstract":"<p><strong>Purpose of review: </strong>Currently, most patients with concurrent head and neck cancer (HNC) and carotid stenosis (CS) are treated disjointedly for their oncologic and vascular lesions. The purpose of this review is to evaluate literature exploring a novel approach to these cases that poses several advantages, in which carotid endarterectomy (CEA) is performed simultaneously with surgical resection of HNC.</p><p><strong>Recent findings: </strong>Carotid stenosis is a common comorbidity of patients presenting with head and neck cancer as these pathologies have overlapping risk factors. Adjuvant oncologic therapy such as radiation therapy to the site of the lesion is known to increase development or progression of carotid stenosis. Performing simultaneous surgical management of CS and HNC decreases total procedures for the patient, provides a less challenging surgical field, and eliminates prioritization of treatment initiation for one pathology over the other. There has been limited reporting of simultaneous CEA with oncologic resection of HNC in the literature. However, of the 21 cases reviewed here, no perioperative strokes were reported with only one perioperative death from myocardial infarction.</p><p><strong>Summary: </strong>Available literature supports that simultaneous CEA with oncologic resection of HNC is safe and may offer several advantages, although larger studies are required.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429359","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}
Pub Date : 2023-12-01Epub Date: 2023-11-02DOI: 10.1097/MOO.0000000000000923
Jacqui Allen
{"title":"Spare a thought for swallowing.","authors":"Jacqui Allen","doi":"10.1097/MOO.0000000000000923","DOIUrl":"10.1097/MOO.0000000000000923","url":null,"abstract":"","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429361","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}
Pub Date : 2023-12-01Epub Date: 2023-09-07DOI: 10.1097/MOO.0000000000000924
Kate Davidson, Haley Sibley, Ashli K O'Rourke
Purpose of review: This review article aims to discuss the clinical presentation and diagnosis of rumination syndrome and supragastric belching, as well as treatment options for both diseases.
Recent findings: Functional gastrointestinal disorders such as rumination syndrome and supragastric belching may be effectively treated using biofeedback.
Summary: A comprehensive approach that includes potential pharmacologic treatments, cognitive behavioral therapy and biofeedback should also be considered for optimal management of supragastric belching and rumination.
{"title":"Supragastric belching and rumination syndrome: diagnosis and management.","authors":"Kate Davidson, Haley Sibley, Ashli K O'Rourke","doi":"10.1097/MOO.0000000000000924","DOIUrl":"10.1097/MOO.0000000000000924","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review article aims to discuss the clinical presentation and diagnosis of rumination syndrome and supragastric belching, as well as treatment options for both diseases.</p><p><strong>Recent findings: </strong>Functional gastrointestinal disorders such as rumination syndrome and supragastric belching may be effectively treated using biofeedback.</p><p><strong>Summary: </strong>A comprehensive approach that includes potential pharmacologic treatments, cognitive behavioral therapy and biofeedback should also be considered for optimal management of supragastric belching and rumination.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184571","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}
Pub Date : 2023-12-01Epub Date: 2023-08-04DOI: 10.1097/MOO.0000000000000918
Laurelie R Wishart, Elizabeth C Ward, Graham Galloway
Purpose of review: Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC.
Recent findings: Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis.
Summary: There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.
{"title":"Advances in and applications of imaging and radiomics in head and neck cancer survivorship.","authors":"Laurelie R Wishart, Elizabeth C Ward, Graham Galloway","doi":"10.1097/MOO.0000000000000918","DOIUrl":"10.1097/MOO.0000000000000918","url":null,"abstract":"<p><strong>Purpose of review: </strong>Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC.</p><p><strong>Recent findings: </strong>Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis.</p><p><strong>Summary: </strong>There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319617","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}
Pub Date : 2023-10-01Epub Date: 2023-06-02DOI: 10.1097/MOO.0000000000000908
Madelyn Frank, Mehdi Abouzari, Hamid R Djalilian
Purpose of review: To discuss the theory that Meniere's disease (MD) is a variation of otologic migraine rather than an isolated inner ear condition.
Recent findings: In contrast to the approximately 12% of the general population suffering from migraine headaches, 51-60% of patients with MD experience migraine headaches. While pathognomonic for MD, endolymphatic hydrops has also been identified in patients with vestibular migraine. Treatment with the integrative neurosensory rehabilitation approach (diet and lifestyle changes, magnesium and riboflavin supplementation, and when needed, prophylactic medication) to treat the underlying migraine process has been highly effective in patients with MD.
Summary: MD can be understood as a manifestation of migraine such that patients with MD can be effectively treated with migraine therapies.
{"title":"Meniere's disease is a manifestation of migraine.","authors":"Madelyn Frank, Mehdi Abouzari, Hamid R Djalilian","doi":"10.1097/MOO.0000000000000908","DOIUrl":"10.1097/MOO.0000000000000908","url":null,"abstract":"<p><strong>Purpose of review: </strong>To discuss the theory that Meniere's disease (MD) is a variation of otologic migraine rather than an isolated inner ear condition.</p><p><strong>Recent findings: </strong>In contrast to the approximately 12% of the general population suffering from migraine headaches, 51-60% of patients with MD experience migraine headaches. While pathognomonic for MD, endolymphatic hydrops has also been identified in patients with vestibular migraine. Treatment with the integrative neurosensory rehabilitation approach (diet and lifestyle changes, magnesium and riboflavin supplementation, and when needed, prophylactic medication) to treat the underlying migraine process has been highly effective in patients with MD.</p><p><strong>Summary: </strong>MD can be understood as a manifestation of migraine such that patients with MD can be effectively treated with migraine therapies.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213973","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}
Pub Date : 2023-10-01DOI: 10.1097/moo.0000000000000915
Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Ravi Samy and Nael ShomanRavi Samy and Nael ShomanDr Ravi N. Samy, MD, FACS is Chief of the Division of Otology/Neurotology and Associate Professor in the Department of Otolaryngology – Head and Neck Surgery at the University of Cincinnati / Cincinnati Children's Hospital Medical Center, USA. Dr Ravi N. Samy has been a Neurotologist at the University of Cincinnati / Cincinnati Children's Medical Center Gardner Neuroscience Institute and the program director of the Neurotology Fellowship at the UC College of Medicine since 2005. He is also the director of the Adult Auditory Implant Program as well as a Professor of Otolaryngology. Dr Samy was born in what is now known as Chennai, India, and immigrated to the United States at the age of 4. After living for one year in Canton, Ohio and 3 years in Connecticut, he spent most of his formative years living in Texas. He went to Duke University in North Carolina for his undergraduate education. After graduating magna cum laude with a bachelor's degree in zoology, Dr Samy attended the Duke University School of Medicine until his graduation in 1995. He then completed his resident training at Stanford University School of Medicine, where he developed a love for otology, neurotology and skull base surgery. Dr Samy spent two years at the University of Iowa as a Neurotology fellow before moving back to Texas to be an assistant professor at the UT-Southwestern Medical Center in Dallas. Dr Samy decided to move to Cincinnati because he was enamored with the phenomenal academic opportunity he found in the Department of Otolaryngology at UCMC and Cincinnati Children's Hospital Medical Center (CCHMC). During his time at UCMC he has created an ACGME accredited, two-year Neurotology fellowship, which is one of approximately 20 in the country. His research interests include cochlear and auditory brainstem implantation as well as acoustic neuromas, neurofibromatosis type 2, facial nerve tumors and other diseases and disorders of the lateral skull base. Dr Samy is also interested in using novel techniques and technologies to eradicate tumors, such as the use oncolytic virotherapy. He is collaborating with researchers in India to incorporate these technologies to enhance global health and increase collaboration between UC and international institutions, thus benefiting both US citizens and those of other nations. Robert
《耳鼻咽喉头颈外科最新意见》创刊于1993年。它是一系列成功的评论期刊之一,其独特的格式旨在提供许多主要期刊中提出的文献的系统和批判性评估。耳鼻喉科和头颈外科分为11个部分,每年复习一次。每个章节都有一个章节编辑,他是该领域的权威,负责确定当时最重要的主题。在这里,我们很高兴地介绍本刊的栏目编辑。Ravi N. Samy,医学博士,美国辛辛那提大学/辛辛那提儿童医院医学中心耳科/神经内科主任,耳鼻喉科-头颈外科副教授。Ravi N. Samy博士自2005年以来一直是辛辛那提大学/辛辛那提儿童医学中心加德纳神经科学研究所的神经学家,也是加州大学医学院神经学奖学金项目主任。他也是成人听觉植入项目的主任,也是耳鼻喉科的教授。萨米博士出生在现在的印度金奈,4岁时移民到美国。在俄亥俄州坎顿生活了一年,在康涅狄格州生活了三年之后,他在德克萨斯州度过了大部分的成长岁月。他去了北卡罗来纳州的杜克大学(Duke University)接受本科教育。在以优异成绩获得动物学学士学位后,Samy博士进入杜克大学医学院学习,直到1995年毕业。然后,他在斯坦福大学医学院完成了住院医师培训,在那里他对耳科、神经学和颅底外科产生了兴趣。萨米博士在爱荷华大学(University of Iowa)做了两年神经学研究员,之后回到德克萨斯州,在达拉斯的ut -西南医学中心(UT-Southwestern Medical Center)担任助理教授。Samy博士决定搬到辛辛那提,因为他被UCMC耳鼻喉科和辛辛那提儿童医院医疗中心(CCHMC)的非凡学术机会所吸引。在UCMC工作期间,他创建了ACGME认证的两年神经学奖学金,这是全国约20个神经学奖学金之一。主要研究方向为耳蜗、听脑干植入及听神经瘤、2型神经纤维瘤病、面神经肿瘤等侧颅底疾病和障碍。Samy博士对使用新技术和技术来根除肿瘤也很感兴趣,比如使用溶瘤病毒疗法。他正在与印度的研究人员合作,将这些技术纳入全球健康领域,并加强加州大学与国际机构之间的合作,从而使美国公民和其他国家的公民都受益。Robert S. Hong博士,医学博士,密歇根耳研究所的合伙人、首席财务官和研究总监。他也是韦恩州立大学耳鼻喉科-头颈外科的副教授,并在奥克兰大学威廉博蒙特医学院和密歇根州立大学人类医学院共同任职。洪博士在哈佛大学获得本科学位,在加州大学欧文分校获得医学学位。他在爱荷华大学完成了耳鼻喉科住院医师,并在密歇根耳科研究所获得了耳部和颅底外科的认证奖学金。他是成人和儿童神经学、耳科、耳鼻喉科和颅底外科的认证医师。他拥有爱荷华大学的言语和听力科学博士学位,他的工作是提高人工耳蜗受者对噪音中的言语的理解。他还完成了由美国国立卫生研究院和多丽丝·杜克基金会赞助的研究奖学金。洪医生是美国耳鼻喉头颈外科学会、美国神经学会、耳硬化研究小组和密歇根耳鼻喉学会的成员。他是ANS社交媒体委员会主席,并担任密歇根耳鼻喉学会的当选总统。他曾担任多项临床研究的首席研究员,包括涉及梅尼埃氏病、耳鸣、耳硬化、人工耳蜗和其他植入式听力设备的研究。洪医生是密歇根州狮子会基金会Robert H. Mathog Lions听力中心的首席医疗主任,该基金会是一家慈善组织,致力于通过筛查、诊断、治疗、教育和研究为个人和社区提供听力相关服务,无论其支付能力如何。 他也是密歇根州狮子听力中心的前任主席和密歇根州耳科研究所狮子听力诊所的前任主任。
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