3,770 results match your criteria Otolaryngologic clinics of North America[Journal]


Office-based Procedures in Otolaryngology.

Otolaryngol Clin North Am 2019 Apr 12. Epub 2019 Apr 12.

Department of Otolaryngology-HNS, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2019.03.001DOI Listing

Coding for Otolaryngology Office Procedures.

Otolaryngol Clin North Am 2019 Apr 5. Epub 2019 Apr 5.

LSU Health Sciences Center, Department of Otolaryngology-Head and Neck Surgery, University Hospital and Clinics, 2390 West Congress Street, Lafayette, LA 70506, USA.

This review article provides a summary of current correct coding for in-office surgical procedures. The relevant Current Procedural Terminology codes are covered and tips and guidance provided for their correct use. Also, where applicable, facility versus nonfacility reimbursement policy and the associated implications for physicians practicing in hospital-based clinics are discussed. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.014DOI Listing

Minimally Invasive Facial Cosmetic Procedures.

Otolaryngol Clin North Am 2019 Apr 4. Epub 2019 Apr 4.

PLLC Plastic & Reconstructive Surgery, 969 Park Ave Suite 1G New York, NY 10028, USA; Georgetown University, Washington, DC, USA.

Minimally invasive procedures including neurotoxins, dermal fillers, deoxycholic acid, lasers, peels, and microneedling offer powerful, less permanent adjuncts to surgery that are highly effective in select patients. Injectables and skin resurfacing techniques target facial irregularities including wrinkles and fine lines, decrease in volume and contour, and unwanted fat. Determining the best approach for a given patient involves careful consideration of the patient's health conditions, unique anatomic characteristics, tissue quality, and desired results. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.013DOI Listing
April 2019
2 Reads
1.341 Impact Factor

Surgical Cosmetic Procedures of the Face.

Otolaryngol Clin North Am 2019 Apr 4. Epub 2019 Apr 4.

PLLC Plastic & Reconstructive Surgery, 969 Park Avenue, New York, NY 10028, USA; Georgetown University, Washington, DC, USA.

Surgical techniques for cosmetic facial rejuvenation, antiaging concerns, and the optimization of facial beauty can be nuanced and complex. Generally speaking, surgical interventions, including facelift, necklift, blepharoplasty, and rhinoplasty, are the gold standard approaches for the enhancement of facial features. A detailed understanding of facial anatomy, aesthetics, and techniques is necessary to master these approaches. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.001DOI Listing
April 2019
1 Read
1.341 Impact Factor

In-Office Ultrasonographic Evaluation of Neck Masses/Thyroid Nodules.

Otolaryngol Clin North Am 2019 Apr 4. Epub 2019 Apr 4.

Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, 243, Charles Street, Boston, MA 02114, USA; Division of Surgical Oncology, Endocrine Surgery Service, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Office-based ultrasonography is increasingly becoming an integral part of an otolaryngology-head and neck surgery practice. A thorough knowledge of the ultrasonic appearance of normal and abnormal pathology are key for performing/interpreting office-based head and neck ultrasonography. A focused but systematic approach allows for efficient and effective office-based head and neck ultrasonography. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.012DOI Listing
April 2019
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Office-Based 532-Nanometer Pulsed Potassium-Titanyl-Phosphate Laser Procedures in Laryngology.

Otolaryngol Clin North Am 2019 Mar 26. Epub 2019 Mar 26.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Voice Center, University of Texas Health Science Center-San Antonio, 8431 Fredricksburg Road, San Antonio, TX 78229, USA.

With fiber-based lasers that may be passed via the working channel of a flexible laryngoscope, in-office laser laryngeal surgery has become possible. The potassium-titanyl-phosphate laser has several features that make it ideal for laryngeal surgery, and it is now the laser of choice for in-office management of a variety of laryngeal lesions. Its applications have expanded significantly since its introduction, with reports of new indications continuing to appear in the literature. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.011DOI Listing
March 2019
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Reprocessing Flexible Endoscopes in the Otolaryngology Clinic.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

2033 Norfolk Street, Ann Arbor, MI 48103, USA.

Reprocessing a flexible endoscope is a complex multistep process. Attention to detail is essential for patient safety. Physicians need to empower their staff to function as guardians and advocates for best practices in endoscope reprocessing. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665193001
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http://dx.doi.org/10.1016/j.otc.2019.02.009DOI Listing
March 2019
2 Reads

In-office Functional Nasal Surgery.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Division of Facial Plastic, Aesthetic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 1130 W. Michigan Street, Suite 400, Indianapolis, IN 46202, USA. Electronic address:

Nasal airway obstruction is a common complaint encountered by the otolaryngologist. In-office nasal procedures are becoming increasingly popular and should be considered for patients desiring immediate treatment without the adverse effects of general anesthesia, operating room costs, or scheduling delays. This article discusses the factors in patient selection, room setup, and other considerations. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.010DOI Listing

Mohs Reconstruction and Scar Revision.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, 714 Kellogg Eye Center, Ann Arbor, MI 48109, USA.

Facial reconstruction may be effectively performed in an office setting using a variety of techniques. Careful patient selection is paramount for achieving successful outcomes in this setting. The most common reconstructive techniques used in the office setting include local flaps and skin grafts. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.002DOI Listing

In-Office Laryngology Injections.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam, Houston, TX 78234, USA.

The ability to perform in-office vocal fold injections has been greatly enhanced by advances in videolaryngoscopy technology. With improved optics and thin, channeled flexible laryngoscopes, in-office laryngeal injections have expanded from vocal fold augmentation for glottic insufficiency, vocal cold immobility, and botulinum toxin injections for spasmodic dysphonia, to vocal fold steroid injections for benign vocal fold lesions and scars and various injections for neurogenic cough. Efficacy, approaches, post-procedure management, and common complications of in-office laryngeal injections are outlined and supporting evidence discussed. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.006DOI Listing
March 2019
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Office-Based Otology Procedures.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA.

Endoscopy has changed the practice of otology in both operative and clinic settings. Endoscopes increase the visibility of anterior tympanic perforations expanding the criteria for in-office repair. Endoscopic myringoplasty techniques using tissue-engineered grafts and porcine-based extracellular grafts are described. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.004DOI Listing

Office-Based Sinus Surgery.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address:

Office-based rhinologic procedures have seen a dramatic rise in incidence over the last decade. It is crucial to select appropriate patients and understand which pathologies may be amenable to in-office procedures. It behooves the otolaryngologist to be familiar with the array of technologic advances that are expanding the limits of office-based rhinology and to have a solid understanding of the technical nuances of using these technologies in the clinic. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.003DOI Listing

In-Office Evaluation and Management of Dysphagia.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Department of Otolaryngology, Voice, Airway and Swallowing Center, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA 30912, USA.

Dysphagia is a common complaint encountered in otolaryngology clinics. Approaching the patient with dysphagia starts with a comprehensive symptomatic analysis and thorough physical examination. The recent rapid revolution in office-based procedures has a great impact in the evaluation and management of dysphagia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665193000
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http://dx.doi.org/10.1016/j.otc.2019.02.007DOI Listing
March 2019
4 Reads

Patient Safety and Anesthesia Considerations for Office-Based Otolaryngology Procedures.

Otolaryngol Clin North Am 2019 Mar 21. Epub 2019 Mar 21.

Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, 3440 N, Broad Street, Kresge West, 3rd Floor, Room 309, Philadelphia, PA 19140, USA. Electronic address:

Office-based otolaryngology procedures provide a safe and efficient alternative to the traditional operating room. Physicians are responsible for knowing their state regulations and subspecialty guidelines. Although the clinic setting has fewer regulations than hospitals and ambulatory surgery centers, the clinic has the same standards as a hospital with respect to emergency equipment, trained personnel, protocols, and safety measures. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665193001
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http://dx.doi.org/10.1016/j.otc.2019.02.008DOI Listing
March 2019
7 Reads

In-Office Balloon Dilation of the Eustachian Tube under Local Anesthesia.

Otolaryngol Clin North Am 2019 Mar 22. Epub 2019 Mar 22.

Otolaryngology, West Ann Arbor Health Center, University of Michigan, 380 Parkland Plaza, Ann Arbor, MI 48103-6021, USA.

Balloon dilation of the Eustachian tube (BDET) is an effective treatment of Eustachian tube dysfunction. This procedure can be performed under local anesthesia in the office. This article outlines the evolution of BDET under local anesthesia, describes the techniques of in-office BDET and provides an algorithm to identify suitable patients for this procedure. Read More

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http://dx.doi.org/10.1016/j.otc.2019.02.005DOI Listing

Implantable Auditory Devices: Bridging the Gap Between Conventional Hearing Aids and Cochlear Implants.

Otolaryngol Clin North Am 2019 Apr;52(2):xv-xvi

ENT and Allergy Associates, LLP, 18 East 48th Street, 2nd Floor, New York, NY 10017, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2018.11.018DOI Listing
April 2019
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Bridging the Sizeable Gap Between Hearing Aids and Cochlear Implants.

Otolaryngol Clin North Am 2019 Apr;52(2):xiii-xiv

ENT and Allergy Associates, LLP, 18 East 48th Street, 2nd Floor, New York, NY 10017, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2018.11.019DOI Listing

Implantable Auditory Devices: Financial Considerations and Office-Based Implantation.

Otolaryngol Clin North Am 2019 Apr;52(2):357-361

Research for the Ear Research Foundation, Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, USA.

Hearing rehabilitation has been recognized as a crucial tool to maintain communicative and social skills. The availability of hearing aids and auditory implants ought not be limited to the wealthy and to those who can afford them. Multidisciplinary efforts in reducing costs are necessary and include reduction of the item costs, insurance coverage, and the ability to perform certain procedures in an office setting, eliminating hospital and facilities fees and anesthesia bills. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183025
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http://dx.doi.org/10.1016/j.otc.2018.11.012DOI Listing
April 2019
2 Reads

Special Populations in Implantable Auditory Devices: Pediatric.

Otolaryngol Clin North Am 2019 Apr;52(2):323-330

Division of Pediatric Otolaryngology, Children's National Health System, George Washington University School of Medicine, 111 Michigan Avenue Northwest, Washington, DC 20010, USA. Electronic address:

"Hearing loss in the pediatric population can have significant social and developmental implications. Early auditory rehabilitation by at least 6 months of age is imperative. Although traditional hearing aids are often a first-line treatment option, there is a wide array of implantable auditory devices available. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.015DOI Listing
April 2019
2 Reads

Ossicle Coupling Active Implantable Auditory Devices: Magnetic Driven System.

Authors:
C Y Joseph Chang

Otolaryngol Clin North Am 2019 Apr;52(2):273-283

Texas Ear Center, 7900 Fannin, Suite 1800, Houston, TX 77054, USA; Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas McGovern Medical School, Houston, TX, USA. Electronic address:

Active auditory implants, such as the Maxum, provide significantly improved hearing function compared to hearing aids in patients with moderate to severe hearing loss who are not reaching their cochlear hearing potential. The speech perception gap (SPG), defined as PB Max (phonetically balanced maximum) minus word recognition score with hearing aid, is a useful measure of inadequate hearing aid performance. The Maxum middle ear implant provides significantly improved performance over hearing aids in patients with significant SPG because of superior high frequency gain. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.014DOI Listing
April 2019
2 Reads

Osseointegrated Auditory Devices-Transcutaneous: Sophono and Baha Attract.

Otolaryngol Clin North Am 2019 Apr;52(2):253-263

Otology- Neurotology, Ear Nose and Throat Associates of New York, 35-30 Francis Lewis Boulevard, Auburndale, NY 11358, USA.

Percutaneous osseointegrated bone conduction auditory devices provide excellent auditory rehabilitation. Device-related complications relate to skin abutment interface and cosmetic concerns, resulting in the development of transcutaneous devices. The Sophono and Baha Attract are safe and considered cosmetically superior to the percutaneous Baha Connect and Ponto. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.013DOI Listing

Medical and Audiological Indications for Implantable Auditory Devices.

Otolaryngol Clin North Am 2019 Apr;52(2):195-210

Department of Otolaryngology, Long Island Jewish Medical Center, Hearing and Speech Center, Northwell Health, 430 Lakeville Road, New Hyde Park, NY 11042, USA.

Implantable auditory devices (IADs) are a viable hearing restoration option for patients with hearing loss. Conditions such as chronic otitis externa, congenital aural atresia, and chronic otitis media can be treated with a variety of implants. Progressive disease are also amenable to restoration with IADs, providing stabilized hearing. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.001DOI Listing
April 2019
3 Reads

Totally Implantable Active Middle Ear Implants.

Otolaryngol Clin North Am 2019 Apr 12;52(2):297-309. Epub 2019 Feb 12.

Shohet Ear Associates, 446 Old Newport Boulevard #100, Newport Beach, Orange County, CA 92663, USA.

The Envoy Esteem and the Carina system are the 2 totally implantable hearing devices. The Esteem is designed for patients with bilateral moderate to severe sensorineural hearing loss who have an unaided speech discrimination score of greater than and equal to 40%. The Carina system is designed for patients with moderate to severe sensorineural hearing loss or those with mixed hearing loss. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.011DOI Listing

Special Populations in Implantable Auditory Devices: Developmentally Challenged and Additional Disabilities.

Otolaryngol Clin North Am 2019 Apr 12;52(2):341-347. Epub 2019 Feb 12.

Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, 11234 Anderson St. Rm 2586A, Loma Linda, CA 92354, USA.

Children with hearing loss and additional disabilities can benefit from cochlear implants and other implantable auditory devices. Although each individual child must be evaluated, and families uniquely counseled on goals and realistic expectations, overall many gains and benefits are possible in this population. In this article, an overview of the considerations for this group is discussed and outcomes are reviewed, including auditory and speech measures as well as benefits in other skills and quality of life. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.010DOI Listing

Special Populations in Implantable Auditory Devices: Geriatric.

Authors:
Selena E Briggs

Otolaryngol Clin North Am 2019 Apr 12;52(2):331-339. Epub 2019 Feb 12.

Department of Otolaryngology, MedStar Washington Hospital Center, 106 Irving Street NW, Suite 2700 North, Washington, DC 20010; Department of Otolaryngology, MedStar Georgetown University Medical Center, Gorman Building, 1st Floor, 3800 Reservoir Road NW, Washington, DC 20007. Electronic address:

Hearing loss is common in the geriatric population. Most hearing loss is associated with presbycusis or age-related hearing loss, impacting one-third of individuals over 65 years and increasing in prevalence with age. Hearing loss impacts quality of life, psychological health, and cognition. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.009DOI Listing
April 2019
2 Reads

Future of Implantable Auditory Devices.

Otolaryngol Clin North Am 2019 Apr 12;52(2):363-378. Epub 2019 Feb 12.

The Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, 800 Stanton L Young Boulevard, Suite 1400, Oklahoma City, OK 73104, USA. Electronic address:

The advances in technology leading to rapid developments in implantable auditory devices are constantly evolving. Devices are becoming smaller, less visible, and more efficient. The ability to preserve hearing outcomes with cochlear implantation will continue to evolve as surgical techniques improve with the use of continuous feedback during the procedure as well as with intraoperative delivery of drugs and robot assistance. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.017DOI Listing

Auditory Neuropathy: Bridging the Gap Between Hearing Aids and Cochlear Implants.

Otolaryngol Clin North Am 2019 Apr 12;52(2):349-355. Epub 2019 Feb 12.

The Otology Group of Vanderbilt, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605, USA. Electronic address:

Auditory neuropathy spectrum disorder (ANSD) is a complex and heterogeneous disorder associated with altered neural synchrony with respect to auditory stimuli. Patients have characteristic auditory findings including normal otoacoustic emissions in the setting of abnormal auditory brainstem response. Patients with ANSD have a high incidence of comorbid developmental delay that may impact speech outcomes. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.016DOI Listing

Electroacoustic Stimulation.

Otolaryngol Clin North Am 2019 Apr 5;52(2):311-322. Epub 2019 Jan 5.

Cochlear Implant Program, Department of Otolaryngology, Columbia University Medical Center, 180 Fort Washington Avenue, Harkness Pavilion 8th Floor, Room 864, New York, NY 10032, USA. Electronic address:

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.008DOI Listing

Osseointegrated Auditory Devices: Bone-Anchored Hearing Aid and PONTO.

Otolaryngol Clin North Am 2019 Apr 5;52(2):243-251. Epub 2019 Jan 5.

Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, 3509 North Broad Street, Suite 300, Philadelphia, PA 19140, USA.

Osseointegrated auditory devices (OADs) are hearing devices that use an external receiver/processor that stimulates bone conduction of sound via a titanium prosthesis that is drilled into the bone of the cranium. Since their introduction in 1977, OADs have undergone substantial evolution, including changes in manufacturing of the implant, improvements in the external sound processor, and simplification of implantation techniques. Expansion of criteria for patient candidacy for implantation has occurred corresponding with changes in the implants and processors. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.005DOI Listing
April 2019
2 Reads

Physiology of Osseointegration.

Otolaryngol Clin North Am 2019 Apr 3;52(2):231-242. Epub 2019 Jan 3.

Otology and Skull Base Unit, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB20QQ, UK.

"Bone conduction implant devices rely on osseointegration of titanium implants with the underlying skull, characterized by endosseous healing and de-novo bone formation both surrounding and onto the implant surface. The key steps in osseointegration are the initial tissue response to implantation, peri-implant osteogenesis, and peri-implant bone remodeling. There is increasing evidence that osseointegration is primarily an immune-mediated process with the key players being the complement cascade and macrophages, which form part of the host innate immunity. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.004DOI Listing
April 2019
3 Reads

Osseointegrated Auditory Devices: Bonebridge.

Authors:
Mia E Miller

Otolaryngol Clin North Am 2019 Apr 3;52(2):265-272. Epub 2019 Jan 3.

House Clinic, 2100 West 3rd Street, Suite 111, Los Angeles, CA 90057, USA. Electronic address:

Bonebridge is an active bone conduction device that consists of a bone conduction-floating mass transducer (BC-FMT) and magnet internally and an audio processor externally. Surgery for implantation can be performed under local anesthesia but requires surgical planning for adequate bone depth for the BC-FMT well. Bonebridge does not require osseointegration to function, so the device can be activated early. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.006DOI Listing

The Vibrant Soundbridge: A Global Overview.

Authors:
Jennifer Maw

Otolaryngol Clin North Am 2019 Apr 3;52(2):285-295. Epub 2019 Jan 3.

Department of Otolaryngology Head and Neck Surgery, Stanford University, Stanford, California; Ear Associates and Rehabilitation Services, Inc., San Jose, California. Electronic address:

The Vibrant Soundbridge is a semi-implantable, active middle ear implant that is a safe and effective treatment for patients with sensorineural hearing loss. Since Food and Drug Administration approval for this indication, many international investigators have expanded its use for conductive and mixed hearing losses. This article reviews the author's experience and the international uses of this versatile device. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.007DOI Listing
April 2019
1 Read

Extended-Wear Hearing Technology: The Nonimplantables.

Otolaryngol Clin North Am 2019 Apr 3;52(2):221-230. Epub 2019 Jan 3.

New York Otolaryngology Group, 36A East 36th Street, New York, NY 10016, USA.

A new category of hearing technology has emerged that comprises devices inserted deep into the ear canal. Although not implanted, they represent an extension of what is expected of a traditional hearing aid. There are advantages to these devices, but they are not suited for all individuals with hearing loss. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.003DOI Listing
April 2019
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Limitations of Conventional Hearing Aids: Examining Common Complaints and Issues that Can and Cannot Be Remedied.

Authors:
Sara Lerner

Otolaryngol Clin North Am 2019 Apr 3;52(2):211-220. Epub 2019 Jan 3.

ENT and Allergy Associates, 261 5th Avenue, Suite 901, New York, NY 10016, USA. Electronic address:

This article examines and evaluates methods, from an audiologist's perspective, of reducing common complaints with conventional hearing aids and issues such as the occlusion effect, acoustic feedback, discomfort, and insufficient gain. Although often successful, reducing one problem may have the tradeoff of causing another issue. This article is meant to provide information to the reader regarding modern conventional hearing aids, the means to alleviate common problems in the clinic, and when middle ear implants and osseointegrated implants can be beneficial. Read More

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http://dx.doi.org/10.1016/j.otc.2018.11.002DOI Listing

Management of Vestibular Schwannoma (Including NF2): Facial Nerve Considerations.

Otolaryngol Clin North Am 2018 Dec;51(6):1193-1212

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York Eye and Ear of Mount Sinai, Floor 6, 310 East 14th Street, New York, NY 10003, USA. Electronic address:

Current consensus on optimal treatment of vestibular schwannoma remains poorly established; treatment options include observation, stereotactic radiosurgery, microsurgical resection, medical therapy, or a combination of these. Treatment should be individualized and incorporate the multitude of patient- and tumor-specific characteristics known to affect outcome. Treatment paradigms for sporadic and neurofibromatosis type 2-related tumors are distinct and decision-making in neurofibromatosis type 2 is uniquely challenging. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.015DOI Listing
December 2018
14 Reads

Patient Engagement in Otolaryngology.

Otolaryngol Clin North Am 2019 Feb;52(1):23-33

Departments of Otolaryngology-Head and Neck Surgery, Pediatrics, and Health Policy & Management, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, 601 North Caroline Street, Baltimore, MD 21287, USA. Electronic address:

Patient engagement, which involves incorporating the patient and family as partners in their care, is a growing focus in otolaryngology and surgery. Attention to patient and family centeredness, shared decision making, and patient experience together improves the overall tenor of patient engagement. Patient engagement promotes safety through improving quality of electronic health record data, error detection, and treatment decisions and adherence. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183015
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http://dx.doi.org/10.1016/j.otc.2018.08.003DOI Listing
February 2019
14 Reads

Clinical Indices to Drive Quality Improvement in Otolaryngology.

Otolaryngol Clin North Am 2019 Feb;52(1):123-133

Department of Pediatric Otolaryngology, Nationwide Children's Hospital, 555 South 18th Street, Suite 2A, Columbus, OH 43205, USA; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA. Electronic address:

A Pediatric Tracheostomy Care Index (PTCI) was developed by the authors to standardize care and drive quality improvement efforts at their institution. The PTCI comprises 9 elements deemed essential for safe care of children with a tracheostomy tube. Based on the PTCI scores, the number of missed opportunities per patient was tracked, and interventions through a "Plan-Do-Study-Act" approach were performed. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.008DOI Listing
February 2019
20 Reads

Button Battery Safety: Industry and Academic Partnerships to Drive Change.

Otolaryngol Clin North Am 2019 Feb 8;52(1):149-161. Epub 2018 Oct 8.

National Capital Poison Center, 3201 New Mexico Avenue Northwest #310, Washington, DC 20016, USA.

The pediatric button battery (BB) hazard has been recognized for several decades. In 2012, the National Button Battery Task Force was established, and most manufacturers have improved warning labels, more secure packaging, and made BB compartments in products are more secure. Tissue neutralization before BB removal (ie, honey or sucralfate/Carafate®) is an effective way to reduce the rate of BB injury. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183016
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http://dx.doi.org/10.1016/j.otc.2018.08.009DOI Listing
February 2019
28 Reads

Multidisciplinary Tracheostomy Care: How Collaboratives Drive Quality Improvement.

Otolaryngol Clin North Am 2019 Feb 5;52(1):135-147. Epub 2018 Oct 5.

Department of Otolaryngology-Head and Neck Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA. Electronic address:

There have been reports of successful quality-improvement initiatives surrounding tracheostomy care for more than a decade, but widespread adoption of best practices has not been universal. Five key drivers have been found to improve the quality of care for tracheostomy patients: multidisciplinary synchronous ward rounds, standardization of care protocols, appropriate interdisciplinary education and staff allocation, patient and family involvement, and use of data to drive improvement. The Global Tracheostomy Collaborative is a quality-improvement collaborative dedicated to improving the care of tracheostomy patients worldwide through communication, dissemination, and implementation of proven strategies based on these 5 key drivers. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.006DOI Listing
February 2019
25 Reads

Rethinking Morbidity and Mortality Conference.

Otolaryngol Clin North Am 2019 Feb 5;52(1):47-53. Epub 2018 Oct 5.

Department of Otolaryngology, Washington University in St. Louis, School of Medicine, 660 South Euclid Avenue, Campus Box 8115, St Louis, MO 63110, USA.

This article will discuss the importance of an effective morbidity and mortality (M&M) conference toward supporting a proactive and preventative approach to patient safety and quality improvement (PSQI). Key characteristics will be discussed that enhance this process for being a mechanism for driving positive PSQI culture change that permeates the department. The focus of this article will be on how to approach the structure and process of this conference for maximal benefit. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.007DOI Listing
February 2019

Delivering Otolaryngologic Care Safely and Successfully.

Otolaryngol Clin North Am 2019 02 5;52(1):xv-xvii. Epub 2018 Oct 5.

ENT & Allergy Associates, LLP 18 East 48th Street, 2nd Floor New York, NY 10017, USA; Zucker School of Medicine at Hofstra-Northwell Hempstead, NY 11549, USA; Icahn School of Medicine at Mount Sinai New York, NY 10029, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2018.09.002DOI Listing
February 2019

Publicly Available Databases in Otolaryngology Quality Improvement.

Otolaryngol Clin North Am 2019 Feb 5;52(1):185-194. Epub 2018 Oct 5.

Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1325, Chicago, IL 60611, USA; Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 25, Chicago, IL 60611, USA. Electronic address:

The historical context for quality improvement is provided. Important differences are described between the two overarching types of databases: clinical registries and administrative databases. The pros and cons of each are provided as are examples of their utilization in otolaryngology-head and neck surgery. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.004DOI Listing
February 2019
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Management of Flaccid Facial Paralysis of Less Than Two Years' Duration.

Otolaryngol Clin North Am 2018 Dec 5;51(6):1093-1105. Epub 2018 Oct 5.

Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address:

Flaccid facial paralysis results in disfiguring facial changes. The treatment of flaccid facial paralysis is complex and treatment approaches should be determined based on duration and the causes of paralysis, status and accessibility of the affected facial nerve, medical comorbidities, and patient-specific goals. Although primary nerve repair is the preferred treatment strategy when possible, nerve substitution procedures are the mainstay of treatment for patients with flaccid facial paralysis of less than 2 years duration. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.006DOI Listing
December 2018
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Medical Management of Acute Facial Paralysis.

Authors:
Teresa M O

Otolaryngol Clin North Am 2018 Dec 5;51(6):1051-1075. Epub 2018 Oct 5.

Facial Nerve Center, Vascular Birthmark Institute of New York, Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, 210 East 64th Street, 7th Floor, New York, New York, 10065, USA. Electronic address:

Acute facial paralysis (FP) describes acute onset of partial or complete weakness of the facial muscles innervated by the facial nerve. Acute FP occurs within a few hours to days. The differential diagnosis is broad; however, the most common cause is viral-associated Bell Palsy. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.004DOI Listing
December 2018
2 Reads

Patient Safety in Audiology.

Otolaryngol Clin North Am 2019 Feb 1;52(1):75-87. Epub 2018 Oct 1.

American Speech-Language-Hearing Association, 2200 Research Boulevard, Rockville, MD 20850, USA.

There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.017DOI Listing
February 2019
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Patient Safety and Quality Improvement: Driving to New Frontiers.

Authors:
Rahul K Shah

Otolaryngol Clin North Am 2019 02 29;52(1):xix-xx. Epub 2018 Sep 29.

Children's National Medical Center, George Washington University School of Medicine & Health Sciences, West Wing, 5th Floor, Suite 403, 111 Michigan Avenue, NW, Washington, DC 20010, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2018.09.001DOI Listing
February 2019
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Reprocessing Standards for Medical Devices and Equipment in Otolaryngology: Safe Practices for Scopes, Speculums, and Single-Use Devices.

Otolaryngol Clin North Am 2019 Feb 24;52(1):173-183. Epub 2018 Sep 24.

Strategic Partnerships and Innovation, Healthcare Quality and Affordability, Blue Shield of California, 50 Beale Street, San Francisco, CA 94105, USA.

Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.014DOI Listing
February 2019
16 Reads

Leadership Driving Safety and Quality.

Otolaryngol Clin North Am 2019 Feb 24;52(1):11-22. Epub 2018 Sep 24.

Department of Otolaryngology, University of Pittsburgh School of Medicine, The Eye & Ear Institute, 200 Lothrop Street, Suite 500, Pittsburgh PA 15213, USA; Department of Neurological Surgery, University of Pittsburgh School of Medicine, The Eye & Ear Institute, 200 Lothrop Street, Suite 500, Pittsburgh PA 15213, USA.

Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.002DOI Listing
February 2019

Facial Rehabilitation: Evaluation and Treatment Strategies for the Patient with Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 24;51(6):1151-1167. Epub 2018 Sep 24.

Facial Plastic and Reconstructive Surgery Department, Facial Nerve Center, Massachusetts Eye and Ear Infirmary, Facial Nerve Center, 9th Floor, 243 Charles Street, Boston, MA 02114, USA.

This article describes the most widely used clinician-graded and patient-reported outcome measures, and describes facial rehabilitation strategies for acute and chronic facial palsy, and rehabilitation following dynamic facial reanimation surgery. The multimodality rehabilitation of the facial palsy patient is determined by the extent of facial nerve injury, specific functional deficits, the presence of synkinesis, and the patient's individual goals. Appropriate intervention, including patient education, soft tissue mobilization, neuromuscular reeducation, and chemodenervation, decreases facial tension and improves facial muscle motor control, physical function, facial expression, and quality of life. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.011DOI Listing
December 2018
31 Reads

Management of Long-Standing Flaccid Facial Palsy: Static Approaches to the Brow, Midface, and Lower Lip.

Otolaryngol Clin North Am 2018 Dec 24;51(6):1141-1150. Epub 2018 Sep 24.

Facial Nerve Center, Vascular Birthmark Institute of New York, Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, 210 East 64th Street, 7th Floor, New York, NY 10065, USA. Electronic address:

Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. A horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.010DOI Listing
December 2018
6 Reads