1,681 results match your criteria Advances in oto-rhino-laryngology[Journal]


The Aging Vestibular System: Dizziness and Imbalance in the Elderly.

Authors:
Klaus Jahn

Adv Otorhinolaryngol 2019 15;82:143-149. Epub 2019 Jan 15.

Aging in vestibular structures with loss of hair cells in the inner ear starts early in life, but vestibular function usually remains relatively unimpaired up to advanced ages. However, dizziness and imbalance are common in the elderly and have substantial impact on the quality of life. Dizziness interferes with the everyday activities of 30% of persons over age 70. Read More

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http://dx.doi.org/10.1159/000490283DOI Listing
January 2019
2 Reads

An Overview of Central Vertigo Disorders.

Authors:
Paul Ranalli

Adv Otorhinolaryngol 2019 15;82:127-133. Epub 2019 Jan 15.

Head motion recorded by the vestibular labyrinths is conveyed to specific brainstem and cerebellar structures that relay velocity information to eye muscles to stabilize vision, and to the axial and limb muscles necessary to stabilize balance. Neural networks enhance and extend the primary vestibular signal, and create adaptation to movement when appropriate. Pathological lesions to one or more of these structures may cause central vertigo and imbalance, and may be localized by specific forms of nystagmus and other abnormal neurological signs. Read More

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http://dx.doi.org/10.1159/000490281DOI Listing
January 2019
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Special Considerations for the Pediatric Patient.

Adv Otorhinolaryngol 2019 15;82:134-142. Epub 2019 Jan 15.

Children frequently present with complaints of vertigo and/or disequilibrium. The etiology of such diagnoses include inner ear pathology, migraine and its variants, lesions of the central nervous system as well as mental health disorders, among others. The ability to reliably evaluate vestibular end-organ function is central to accurate diagnosis, however, examining children can be challenging. Read More

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http://dx.doi.org/10.1159/000490282DOI Listing
January 2019
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Systemic Disease Considerations in the Management of the Dizzy Patient.

Adv Otorhinolaryngol 2019 15;82:150-163. Epub 2019 Jan 15.

Patients with symptoms of dizziness may present to a wide range of medical services. Awareness of the full breadth of possible diagnoses is thus helpful in managing dizzy patients. This chapter provides a comprehensive review of systemic diseases that may contribute to the complex symptom of dizziness and provide a review of recent advances in each field. Read More

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http://dx.doi.org/10.1159/000490284DOI Listing
January 2019

Psychiatric Considerations in the Management of Dizzy Patients.

Authors:
Jeffrey P Staab

Adv Otorhinolaryngol 2019 15;82:170-179. Epub 2019 Jan 15.

Research over the last 4 decades has revealed a great deal of information about psychiatric and functional causes, consequences, and comorbidity of vestibular syndromes. Primary care clinicians, neurologists, and otologists who are willing to set aside the 20th century notion of "psychogenic dizziness" and incorporate 21st century concepts about 5 behavioral entities into their practices will be rewarded for their efforts with a marked improvement in diagnostic acumen and therapeutic effectiveness. Panic attacks may cause or contribute to acute or episodic vestibular symptoms. Read More

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https://www.karger.com/Article/FullText/490286
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http://dx.doi.org/10.1159/000490286DOI Listing
January 2019
3 Reads

Videonystagmography and Posturography.

Authors:
Carolyn Falls

Adv Otorhinolaryngol 2019 15;82:32-38. Epub 2019 Jan 15.

Videonystagmography (VNG) and posturography are two vestibular assessment techniques that are still in use today. VNG: VNG allows clinicians to observe and record eye movements in real-time. Compared with electronystagmography (ENG), VNG tracings are more detailed and can capture subtle clinical findings. Read More

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https://www.karger.com/Article/FullText/490269
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http://dx.doi.org/10.1159/000490269DOI Listing
January 2019
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Assessment of the Vestibular System: History and Physical Examination.

Adv Otorhinolaryngol 2019 15;82:1-11. Epub 2019 Jan 15.

So common is vertigo that diverse healthcare professionals, from audiologists to orthopedic surgeons, will eventually encounter it in their patients, if not in themselves. So treatable are vestibular disorders that it is an immense advantage to know how to assess the vestibular system. This review summarizes the history and physical examination that will help diagnose common vestibular disorders presenting with vertigo. Read More

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http://dx.doi.org/10.1159/000490267DOI Listing
January 2019

Benign Paroxysmal Positional Vertigo.

Adv Otorhinolaryngol 2019 15;82:67-76. Epub 2019 Jan 15.

Purpose of Chapter: This chapter discusses the recent progress made in understanding the pathophysiology, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV). Recent Findings: Recent evidence supports the canalolithiasis model as the pathophysiological mechanism and predominant subtype of BPPV. Scanning electron micrographs of extracted posterior semicircular canal contents show free-floating otoconia of utricular origin. Read More

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https://www.karger.com/Article/FullText/490273
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http://dx.doi.org/10.1159/000490273DOI Listing
January 2019
8 Reads

Aminoglycoside Vestibulotoxicity.

Authors:
John Rutka

Adv Otorhinolaryngol 2019 15;82:101-110. Epub 2019 Jan 15.

Many pharmaceuticals have ototoxicity (both cochlear and/or vestibular) as part of their adverse medication profile. The aminoglycoside class of antimicrobials has been especially well studied in this regard. Many questions remain unanswered as to how to best monitor and prevent this complication. Read More

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http://dx.doi.org/10.1159/000490277DOI Listing
January 2019
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Vestibular Testing-Rotary Chair and Dynamic Visual Acuity Tests.

Adv Otorhinolaryngol 2019 15;82:39-46. Epub 2019 Jan 15.

The human vestibular system is exquisitely sensitive to detect linear and rotational head acceleration signals, processed in the brainstem and subsequently relayed to the extraocular motor neurons to generate a compensatory eye rotation. This vestibulo-ocular reflex (VOR) ensures clear and stable vision during head rotation, enabling humans to keep gaze on their desired target. In this chapter, we describe the rotary chair - one physiologic measure of the VOR, and the dynamic visual acuity (DVA) test - one behavioral measure of the VOR. Read More

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http://dx.doi.org/10.1159/000490270DOI Listing
January 2019
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Otolith Function Testing.

Adv Otorhinolaryngol 2019 15;82:47-55. Epub 2019 Jan 15.

Two technically simple tests, vestibular evoked myogenic potential (VEMP) and subjective visual vertical/horizontal (SVV/H) test, have the potential to transform otolith function testing from the research laboratory to the outpatient clinic. Cervical- and ocular-VEMPs are short latency surface potentials produced through the activation of saccular and utricular afferents by sound and vibration. They are tests of dynamic otolith function. Read More

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http://dx.doi.org/10.1159/000490271DOI Listing
January 2019

Vestibular Neuritis: Recent Advances in Etiology, Diagnostic Evaluation, and Treatment.

Adv Otorhinolaryngol 2019 15;82:87-92. Epub 2019 Jan 15.

Purpose of Chapter: This chapter highlights the recent advances in etiology, diagnostic evaluation, and management of vestibular neuritis (VN). Recent Findings: The viral hypothesis has been strengthened with new evidence as the main etiology of VN. Recent evidence indicates that bedside oculomotor findings play a critical role in differentiating VN from stroke. Read More

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http://dx.doi.org/10.1159/000490275DOI Listing
January 2019

Video Head Impulse Testing.

Adv Otorhinolaryngol 2019 15;82:56-66. Epub 2019 Jan 15.

The bedside head impulse, first described nearly 20 years ago, is the single most useful clinical test of the human vestibulo-ocular reflex (VOR). The video head impulse test (vHIT), its laboratory counterpart, now enables the objective assessment of the VOR. We examine how the vHIT can be utilized in three common clinical scenarios: the acute vestibular syndrome, recurrent spontaneous vertigo, and chronic imbalance. Read More

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http://dx.doi.org/10.1159/000490272DOI Listing
January 2019

Advances in Vestibular Rehabilitation.

Adv Otorhinolaryngol 2019 15;82:164-169. Epub 2019 Jan 15.

Vestibular rehabilitation is an exercise-based program that has been in existence for over 70 years. A growing body of evidence supports the use of vestibular rehabilitation in patients with vestibular disorders, and evolving research has led to more efficacious interventions. Through central compensation, vestibular rehabilitation is able to improve symptoms of imbalance, falls, fear of falling, oscillopsia, dizziness, vertigo, motion sensitivity and secondary symptoms such as nausea and anxiety. Read More

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http://dx.doi.org/10.1159/000490285DOI Listing
January 2019
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Migraine Associated Vertigo.

Adv Otorhinolaryngol 2019 15;82:119-126. Epub 2019 Jan 15.

This chapter is a brief overview of migraine associated vertigo (MAV), focusing on the points most relevant to the practicing clinician. We review the definition of MAV, theories regarding its underlying pathophysiology, clinical presentation, epidemiology, findings on physical examination and oto vestibular testing, differential diagnosis, management and prognosis. Read More

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http://dx.doi.org/10.1159/000490280DOI Listing
January 2019
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Perilymphatic Fistulas and Superior Semi-Circular Canal Dehiscence Syndrome.

Adv Otorhinolaryngol 2019 15;82:93-100. Epub 2019 Jan 15.

Perilymphatic fistulas (PLF) and superior semi-circular canal dehiscence syndrome (SCDS) are 2 conditions that can present with sound and/or pressure-induced vertigo. PLF should be suspected in cases of trauma or surgery, while a spontaneous PLF is a diagnosis of exclusion. Research is ongoing to identify an ideal biomarker for perilymph. Read More

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http://dx.doi.org/10.1159/000490276DOI Listing
January 2019
3 Reads

Meniere's Disease.

Adv Otorhinolaryngol 2019 15;82:77-86. Epub 2019 Jan 15.

This article reviews 3 aspects of Meniere's disease (MD), which have been recently revisited: namely, the pathologic mechanism causing the attacks of vertigo, the clinical diagnosis, and the medical and surgical treatments. The characteristic attacks of vertigo are unlikely to be due to membrane ruptures, so a hypothesis that the vertigo is caused by a volume of endolymph shifting suddenly from the cochlea into the pars superior is suggested. The definite diagnosis according to the American Academy of Otolaryngology HNS 1995 criteria [13] failed to exclude vestibular migraine sufficiently and a revision in 2015 [14] has partly addressed this problem but another method which stresses the interaction of the cochlear and vestibular symptoms is described. Read More

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http://dx.doi.org/10.1159/000490274DOI Listing
January 2019
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Imaging of Temporal Bone.

Adv Otorhinolaryngol 2019 15;82:12-31. Epub 2019 Jan 15.

Multidetector computed tomography has been the benchmark for visualizing bony changes of the ear, but has recently been challenged by cone-beam computed tomography. In both methods, all inner ear bony structures can be visualized satisfactorily with 2D or 3D imaging. Both methods produce ionizing radiation and induce adverse health effects, especially among children. Read More

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http://dx.doi.org/10.1159/000490268DOI Listing
January 2019
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Post-Traumatic Dizziness: Clinical and Medicolegal Aspects.

Adv Otorhinolaryngol 2019 15;82:111-118. Epub 2019 Jan 15.

Subjective complaints of dizziness after mild-to-moderate traumatic brain injury are common. Alterations in the mode of injury have changed the presentation symptoms. Evolutions in neuroimaging challenge conventional concepts regarding lack of evidence of injury following mild head trauma and provide hope for elucidating the site of lesion in patients with post-traumatic balance symptoms. Read More

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http://dx.doi.org/10.1159/000490279DOI Listing
January 2019
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Treatment Options for Hypopharyngeal Cancer in Developing Countries in Africa/South America/Asia.

Adv Otorhinolaryngol 2019 12;83:159-166. Epub 2019 Feb 12.

Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Hospital, São Paulo, Brazil.

Most cancers occur in developing countries, and therefore, a discussion about cancer care would be incomplete without providing a developing world perspective. This chapter focuses on challenges and practices relating to hypopharyngeal cancer in limited-resource public healthcare systems in developing countries and specifically in Sub-Saharan Africa, India and South America and by extension, most patients in the developing world. Management of hypopharyngeal cancer must be adapted to the availability of specialised diagnostic and therapeutic services, radiotherapy and surgical expertise, and tailored to patient factors such as reliability of follow-up and social support. Read More

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http://dx.doi.org/10.1159/000492360DOI Listing
February 2019

Outcomes of Tumour Control from Primary Treatment of Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:90-108. Epub 2019 Feb 12.

The Royal Marsden Hospital, London, United Kingdom,

Hypopharynx cancer continues to pose a clinically challenging head and neck subsite, driven not only by the unique set of patient, anatomic and disease factors but also by the paucity of robust clinical data to guide clinical decision making. The standard of care of radical surgery (pharyngolaryngectomy) in combination with postoperative radiotherapy was the previously accepted norm in the setting of advanced hypopharynx cancer, but this was often at the expense of significant morbidity. In the absence of survival benefit for advanced staged disease with radical surgical approaches, over the last 2 decades, the philosophy of quality of life in survivors has driven the agenda for new therapeutic approaches. Read More

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http://dx.doi.org/10.1159/000492316DOI Listing
February 2019
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Clinical and Radiological Evaluation of Hypopharyngeal Carcinoma.

Adv Otorhinolaryngol 2019 12;83:35-46. Epub 2019 Feb 12.

Department of Radiology, University of Brescia, Brescia, Italy.

Pre-treatment clinical and radiological evaluations represent a key step in the proper management of hypopharyngeal carcinoma. First, office-based endoscopy allows the assessment of superficial tumor extension, signs of laryngeal infiltration, and the overall residual function of the laryngo-hypopharyngeal complex. Different tools, maneuvers, and techniques can improve this essential diagnostic step and should be considered a prerequisite to direct subsequent investigations and give an initial indication for the most appropriate treatment. Read More

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http://dx.doi.org/10.1159/000492306DOI Listing
February 2019
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Treatment Options for Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:47-53. Epub 2019 Feb 12.

Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom.

Patients with hypopharyngeal cancer are difficult to treat because they typically present with advanced disease, poor general health status and severe nutritional problems. Currently, treatment options for previously untreated and newly diagnosed hypopharyngeal cancer patients include surgery of the primary tumour and lymph nodes metastasis, radiotherapy, systemic medical treatment, including traditional chemotherapy and immunotherapy. Currently, a multimodal treatment approach is preferred using surgery, radiotherapy and systemic therapy with curative intent and best supportive care in patients considered unfit for curative treatment or patients presenting with distant metastatic spread. Read More

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https://www.karger.com/Article/FullText/492308
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February 2019
3 Reads

Symptoms and Signs, Staging and Co-Morbidity of Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:15-26. Epub 2019 Feb 12.

Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom,

Early throat symptoms are common and a diagnosis of hypopharyngeal cancer rare; therefore, confirming or excluding a serious diagnosis is missed or overlooked by both the patient and the practitioner - however, symptoms such as throat clearing and food sticking, which persist in adult patients who have the social habit of tobacco usage and/or drink excessive alcohol should be examined by a specialist to exclude the presence of hypopharyngeal cancer. Late symptoms/signs include neck swelling (uni- or bilateral), dysphagia, odynophagia, otalgia, dysphonia, dyspnoea and stridor. Associated with advancing age and social habits, many patients have co-morbidities such as diabetes mellitus, respiratory, cardiovascular disease and behavioural health disorders that play a major role in selecting the optimal treatment and thus a likely worse long-term outcome. Read More

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http://dx.doi.org/10.1159/000492304DOI Listing
February 2019
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Epidemiology of Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 5;83:1-14. Epub 2019 Feb 5.

Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom,

Hypopharyngeal cancer is uncommon in the developed world; it is mostly diagnosed in men who smoke tobacco and consume excessive alcohol and uncommon in women. However, recent trends in the developed world show that there has been an annual increase in the percentage of women with hypopharyngeal cancer. In France, there has been a significant annual percentage change in the incidence of this form of cancer - a decrease in men and a greater increase in women since the 1980s. Read More

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http://dx.doi.org/10.1159/000492299DOI Listing
February 2019

Systemic Therapy, Palliation and Supportive Care of Patients with Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:148-158. Epub 2019 Feb 12.

Department of Oto-Rhino-Laryngology, Klagenfurt General Hospital, Klagenfurt, Austria.

Hypopharyngeal cancer patients have a very poor prognosis and limited therapeutic options. Seventy to eighty per cent of all hypopharyngeal cancer patients will require palliative and/or end-of-life care for incurable end-stage disease during the course of their illness. The overall proportion of hypopharyngeal cancer patients not qualifying for initial curative treatment, or requiring palliation and supportive care over time is higher than for any other subsite of the head and neck. Read More

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https://www.karger.com/Article/FullText/492359
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http://dx.doi.org/10.1159/000492359DOI Listing
February 2019
2 Reads

Surgical Treatment of Advanced Staged Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:66-75. Epub 2019 Feb 12.

Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China,

It is not uncommon for patients with hypopharyngeal cancer to present at an advanced stage of disease. Surgical treatment provides a cure for the tumour with immediate relief from obstruction to the airway and the swallowing passage. Careful planning of surgery is important to ensure good outcome of treatment and prevent complications, some of which may be fatal. Read More

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http://dx.doi.org/10.1159/000492312DOI Listing
February 2019
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Natural History of Treated and Untreated Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:27-34. Epub 2019 Feb 12.

Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom.

Patients with hypopharyngeal cancers frequently present at advanced stage and in poor general health status. Their natural history is characterised by diffuse local primary disease, mucosal and submucosal spread, early cervical nodal metastasis, and a relatively high rate of distant spread. By the time of initial diagnosis, some 60% of all hypopharyngeal cancer patients will be with stage IV disease, some 5% will present with distant metastases, and almost 40% will have a significant reduction in performance status. Read More

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http://dx.doi.org/10.1159/000492305DOI Listing
February 2019
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Primary Treatment of T1-T2 Hypopharyngeal Cancer: Changing Paradigms.

Adv Otorhinolaryngol 2019 12;83:54-65. Epub 2019 Feb 12.

Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium,

There has been a general shift in the treatment of hypopharyngeal cancer from open surgical techniques (either radical or partial "organ" preserving) toward non-surgi cal "organ preserving" strategies (radiotherapy [RT] or chemoradiotherapy [CRT]) and minimally invasive transoral laser microsurgery (TLM) or transoral robotic surgery (TORS). Oncologic outcomes reported are comparable whatever modality is chosen, but better functional outcomes are observed in the RT/CRT and TLM/TORS-treated patients. Because of the high rate of second primary malignancies, which influences overall survival, one could favor an up-front transoral surgical procedure as a primary treatment modality for early hypoharyngeal carcinoma, leaving the (chemo)radiotherapeutic option open for treatment of a likely later emerging second primary. Read More

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https://www.karger.com/Article/FullText/492310
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http://dx.doi.org/10.1159/000492310DOI Listing
February 2019
4 Reads

Salvage Treatment Options after Failed Primary Treatment of Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:135-147. Epub 2019 Feb 12.

Department of Plastic and Reconstructive Surgery, Head and Neck Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.

Recurrent hypopharyngeal cancer (rHPC) is a high-risk fatal disease associated with poor prognosis and high risk of complications in patients who are suitable to undergo salvage treatment. The treatment of such patients should be managed by a dedicated multidisciplinary team, most frequently a tertiary centre. and with the agreement of the patient. Read More

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https://www.karger.com/Article/FullText/492357
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February 2019
6 Reads

Future Perspectives in Hypopharyngeal Cancer Care.

Adv Otorhinolaryngol 2019 12;83:167-175. Epub 2019 Feb 12.

Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom.

Recent advances in minimal access surgery have shown promise in the treatment of limited hypopharyngeal lesions. In spite of their functionally excellent results in individual patients, it currently remains unlikely that these approaches will gain a more major universal impact on hypopharyngeal cancer care. In advanced stage hypopharyngeal cancer, the use of the traditional radical surgery, such as laryngo-pharyngectomy, is no longer accepted by many patients. Read More

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http://dx.doi.org/10.1159/000492361DOI Listing
February 2019

Quality of Life Outcomes following Treatment of Hypopharyngeal Cancer.

Adv Otorhinolaryngol 2019 12;83:126-134. Epub 2019 Feb 12.

University Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, United Kingdom,

Quality of life (QoL) is an important consideration in the management of individuals with head and neck cancer. The poor prognosis and significant impact of treatment modalities on function of the salivary glands, larynx and pharynx combine to make hypopharyngeal carcinoma a particularly challenging condition to treat. The impact of diagnosis and treatment on health related QoL is substantial. Read More

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http://dx.doi.org/10.1159/000492356DOI Listing
February 2019

Swallowing and Voice Outcomes following Treatment of Hypopharyngeal Cancer: The Need for Supervised Rehabilitation.

Adv Otorhinolaryngol 2019 12;83:118-125. Epub 2019 Feb 12.

Department ENT Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.

Advances in and intensification of treatment in hypopharyngeal cancer have led to an increase in organ preservation and in overall survival. Treatment intensification comes at the cost of more pronounced acute and long-term side effects causing functional impairments in voice and swallowing. Swallowing and voice problems have a significant impact on communication, eating and nutrition, social well-being and quality of life. Read More

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http://dx.doi.org/10.1159/000492355DOI Listing
February 2019
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Sequelae and Complications of Treatment for Hypopharyngeal Cancer: Minimising the Risks.

Adv Otorhinolaryngol 2019 12;83:109-117. Epub 2019 Feb 12.

Department ENT Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.

Treatment of hypopharyngeal cancer depends on the extent and location of the tumour, patient-specific or by factors (age, performance status, co-morbidity) and the presence of psychosocial support. Options available for the treatment of hypopharyngeal cancer consist of surgery and non-surgery - radiotherapy, chemoradiation, bioradiation, or a combination of these modalities. To maintain normal functioning as much as possible, functional organ preservation is widely recommended and generally utilizes radiotherapy and/or chemoradiation. Read More

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http://dx.doi.org/10.1159/000492319DOI Listing
February 2019
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The Current Indications for Non-Surgical Treatment of Hypopharyngeal Cancer.

Authors:
Remco de Bree

Adv Otorhinolaryngol 2019 12;83:76-89. Epub 2019 Feb 12.

Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands,

The management of hypopharyngeal cancer is challenging because of poor patient survival and the potential effects of treatment on breathing, voice and swallowing. In general, early stage hypopharyngeal cancer can be primarily treated by radiotherapy or conservative transoral or open surgery, whereas advanced stage hypopharyngeal cancer can be treated by non-surgical protocols if the patient has no loss of functions (dysfunctional larynx) and/or cartilage invasion (T4a). Factors to determine individualized patient treatment include resectability, tumour volume, distant metastases, comorbidity, age, patient's preference, functional imaging parameters, response on induction chemotherapy and employing functional imaging parameters performed in the pre-treatment phase and repeated in the early treatment phase when employing a non-surgical treatment strategy. Read More

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http://dx.doi.org/10.1159/000492314DOI Listing
February 2019
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Hearing Preservation Cochlear Implant Surgery.

Adv Otorhinolaryngol 2018 6;81:66-73. Epub 2018 Apr 6.

Cochlear implantation (CI), with attempted preservation of residual natural low-frequency hearing, is an increasingly accepted application of this technology, with potential benefits to the patient when listening in noise and in music appreciation. The full extent of the benefits of combining preserved natural hearing and electrical stimulation remain under evaluation. Various factors appear to influence the success of hearing preservation (HP) during CI, including electrode design, surgical approach, insertional trauma, steroid usage and patient factors. Read More

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http://dx.doi.org/10.1159/000485544DOI Listing
October 2018

Hearing Rehabilitation in Neurofibromatosis Type 2.

Adv Otorhinolaryngol 2018 6;81:93-104. Epub 2018 Apr 6.

Bilateral vestibular schwannomas are almost pathognomonic of neurofibromatosis type 2 (NF2). As a result of these tumors, hearing loss is the presenting symptom in 60% of adults and 30% of children with NF2. It is often bilateral. Read More

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http://dx.doi.org/10.1159/000485526DOI Listing
October 2018
2 Reads

Management of Cochlear Nerve Hypoplasia and Aplasia.

Adv Otorhinolaryngol 2018 6;81:81-92. Epub 2018 Apr 6.

Approximately 2% of congenital profound deafness cases are due to cochlear nerve (CN) deficiency. MRI is essential to confirm if the nerve is deficient, but because of limitations with resolution, especially when the internal auditory canal is narrowed, it is often unable to distinguish between hypoplasia and aplasia. A full audiometric test battery should always be performed, even if the MRI suggests CN aplasia, as there will sometimes be evidence of audition. Read More

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https://www.karger.com/Article/FullText/485542
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October 2018
2 Reads

Pharmacological Issues in Hearing Rehabilitation.

Adv Otorhinolaryngol 2018 6;81:114-122. Epub 2018 Apr 6.

Surgery aimed at hearing rehabilitation risks damaging residual inner ear function, especially cochlear implant surgery. Pharmacological intervention to reduce this risk has shown great promise in animal models. The challenge is to deliver medication to the appropriate part of the inner ear in appropriate concentrations for long enough to be effective. Read More

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http://dx.doi.org/10.1159/000485541DOI Listing
October 2018
2 Reads

Diagnosis and Treatment of Perilymphatic Fistula.

Adv Otorhinolaryngol 2018 6;81:133-145. Epub 2018 Apr 6.

Perilymphatic fistula (PLF) is defined as an abnormal communication between the fluid (perilymph)-filled space of the inner ear and the air-filled space of the middle ear and mastoid, or cranial spaces. PLF is located in the round or oval window, fractured bony labyrinth, microfissures, anomalous footplate, and can occur after head trauma or barotrauma, chronic inflammation, or in otic capsule dehiscence. This clinical entity was initially proposed more than a century ago, yet it has remained a topic of controversy for more than 50 years. Read More

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https://www.karger.com/Article/FullText/485579
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October 2018
101 Reads

The Role of the Eustachian Tube in Middle Ear Disease.

Adv Otorhinolaryngol 2018 6;81:146-152. Epub 2018 Apr 6.

The Eustachian tube is a complex structure connecting the middle ear to the nasopharynx that contributes to the normal function of the middle ear. Eustachian tube dysfunction (ETD) is thought to contribute to the majority of middle ear pathology, although the mechanisms and the degree to which it contributes to middle ear disease is poorly understood. We describe the anatomy and physiology of the Eustachian tube, define ETD, discuss the methods for measuring ETD and describe recent advances in treatment. Read More

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https://www.karger.com/Article/FullText/485581
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October 2018
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The Future of Cochlear Implant Design.

Adv Otorhinolaryngol 2018 6;81:105-113. Epub 2018 Apr 6.

This chapter discusses the multifaceted future of cochlear implant design. Current research is focused on novel strategies relating to the electrode array, aiming to improve the neuronal health and spatial selectivity, and reduce the power consumption. Future design iterations will most likely improve the neuronal health by reducing insertion trauma, minimizing the inflammatory pathway that follows electrode insertion or through the use of neurotrophins or stem cells. Read More

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http://dx.doi.org/10.1159/000485540DOI Listing
October 2018
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Intraoperative Auditory System Monitoring.

Adv Otorhinolaryngol 2018 6;81:123-132. Epub 2018 Apr 6.

A new electrophysiological system for intraoperative, continuous, near-real time monitoring of cochlear nerve function through acoustic stimulation in the ear canal and recording of the evoked dorsal cochlear nucleus potentials (DNAPs) by a specially designed DNAP electrode placed directly on the brainstem is described. The system is denominated "(cerebellopontine angle) CPA Master" and is designed for hearing preservation surgery in the cerebello-pontine angle, through the retro-sigmoid or the retro-labyrinthine approach. As an additional novelty within the field, the system allows intraoperative mapping and thus precise localization of the cochlear nerve in its entire trajectory from the brainstem to the fundus of the internal auditory canal, which is a major advance in relation to atraumatic dissection of the nerve. Read More

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http://dx.doi.org/10.1159/000485577DOI Listing
October 2018
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New Imaging Modalities in Otology.

Adv Otorhinolaryngol 2018 6;81:1-13. Epub 2018 Apr 6.

Despite steady improvements in cross-sectional imaging of the ear, current technologies still have limitations in terms of resolution, diagnosis, functional assessment and safety. In this chapter, state-of-the-art imaging techniques in current clinical practice are presented including cone-beam computerized tomography, non-echo planar imaging magnetic resonance imaging, imaging for labyrinthine hydrops and imaging of the central auditory pathways. Potential future imaging modalities are also presented, including optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) of the ear. Read More

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http://dx.doi.org/10.1159/000485576DOI Listing
October 2018
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Hearing Rehabilitation with Active Middle Ear Implants.

Adv Otorhinolaryngol 2018 6;81:43-56. Epub 2018 Apr 6.

Hearing implant technology is evolving at a rapid rate and more than ever patients with hearing loss are benefiting from these emerging hearing devices. Active middle ear implants are alternatives to hearing aids and bone conducting devices, offering patients an expanded range in improving their hearing. This chapter looks at the devices currently available, their indications and the literature regarding their outcomes. Read More

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https://www.karger.com/Article/FullText/485529
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http://dx.doi.org/10.1159/000485529DOI Listing
October 2018
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Optimizing Ossicular Prosthesis Design and Placement.

Authors:
Manohar Bance

Adv Otorhinolaryngol 2018 6;81:14-23. Epub 2018 Apr 6.

Middle ear hearing reconstruction is unpredictable. Difficulties arise because of host factors, such as ventilation or scarring, surgical technique factors, such as prosthesis placement and stabilization, and design and mechanical factors influencing the properties of the prosthesis. Often there is a balancing act between choosing optimal stability, and maximizing the mechanical vibrations of the prosthesis. Read More

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https://www.karger.com/Article/FullText/485545
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http://dx.doi.org/10.1159/000485545DOI Listing
October 2018
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Brain Plasticity and Rehabilitation with a Cochlear Implant.

Authors:
Colette M McKay

Adv Otorhinolaryngol 2018 6;81:57-65. Epub 2018 Apr 6.

The functional changes that occur in the brain due to deafness may affect the way the auditory system processes sound after cochlear implantation. Brain plasticity plays a crucial role in the success of cochlear implantation to facilitate or develop spoken language in profoundly deaf individuals. The functional plasticity that occurs in postlingually deaf adults during periods of deafness can both support and hinder speech understanding with a cochlear implant, depending on the nature and degree of functional changes. Read More

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http://dx.doi.org/10.1159/000485586DOI Listing
October 2018

Hearing Rehabilitation in Congenital Middle Ear Malformation.

Authors:
Henning Frenzel

Adv Otorhinolaryngol 2018 6;81:32-42. Epub 2018 Apr 6.

Microtia and atresia cause significant conductive hearing loss of up to 60 dB HL. The bilateral cases suffer from severely restricted communication abilities and require immediate acoustic stimulation. There is also growing evidence that unilateral cases benefit from an early and selective stimulation of the affected side. Read More

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http://dx.doi.org/10.1159/000485525DOI Listing
October 2018

Advances in the Field of Bone Conduction Hearing Implants.

Adv Otorhinolaryngol 2018 6;81:24-31. Epub 2018 Apr 6.

The number of marketed bone-conduction hearing implants (BCHIs) has been steadily growing, with multiple percutaneous devices and transcutaneous devices now available. However, studies assessing efficacy often have small sample sizes and employ different assessment methodologies. Thus, there is a paucity of evidence to guide clinicians to the most appropriate device for each patient. Read More

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http://dx.doi.org/10.1159/000485587DOI Listing
October 2018
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Extended Applications for Cochlear Implantation.

Adv Otorhinolaryngol 2018 6;81:74-80. Epub 2018 Apr 6.

The indications for cochlear implantation (CI) have expanded over the last few years. There is evidence that some adult patients with pre- or perilingual onset of deafness may gain from implantation. Similarly, CI in patients with single-sided deafness may offer significant benefits in terms of quality of life and social as well as academic development. Read More

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http://dx.doi.org/10.1159/000485546DOI Listing
October 2018
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