3,748 results match your criteria Otolaryngologic clinics of North America[Journal]


Totally Implantable Active Middle Ear Implants.

Otolaryngol Clin North Am 2019 Feb 12. 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
February 2019

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

Otolaryngol Clin North Am 2019 Feb 11. Epub 2019 Feb 11.

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
February 2019

Special Populations in Implantable Auditory Devices: Geriatric.

Authors:
Selena E Briggs

Otolaryngol Clin North Am 2019 Feb 11. Epub 2019 Feb 11.

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
February 2019

Future of Implantable Auditory Devices.

Otolaryngol Clin North Am 2019 Feb 11. Epub 2019 Feb 11.

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
February 2019

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

Otolaryngol Clin North Am 2019 Feb 11. Epub 2019 Feb 11.

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
February 2019

Electroacoustic Stimulation.

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

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
January 2019

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

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

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
January 2019
2 Reads

Physiology of Osseointegration.

Otolaryngol Clin North Am 2019 Jan 3. 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
January 2019

Osseointegrated Auditory Devices: Bonebridge.

Authors:
Mia E Miller

Otolaryngol Clin North Am 2019 Jan 3. 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
January 2019

The Vibrant Soundbridge: A Global Overview.

Authors:
Jennifer Maw

Otolaryngol Clin North Am 2019 Jan 3. 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
January 2019
1 Read

Extended-Wear Hearing Technology: The Nonimplantables.

Otolaryngol Clin North Am 2019 Jan 3. 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
January 2019
1 Read

Limitations of Conventional Hearing Aids: Examining Common Complaints and Issues that Can and Cannot Be Remedied.

Authors:
Sara Lerner

Otolaryngol Clin North Am 2019 Jan 3. 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
January 2019

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
8 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
7 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
14 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
18 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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183016
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http://dx.doi.org/10.1016/j.otc.2018.08.006DOI Listing
February 2019
15 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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183015
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http://dx.doi.org/10.1016/j.otc.2018.08.004DOI Listing
February 2019
1 Read

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
1 Read

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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183012
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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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183017
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http://dx.doi.org/10.1016/j.otc.2018.08.017DOI Listing
February 2019
2 Reads

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

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
12 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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.011DOI Listing
December 2018
25 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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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.010DOI Listing
December 2018
3 Reads

Simulation Saves the Day (and Patient).

Otolaryngol Clin North Am 2019 Feb 22;52(1):115-121. Epub 2018 Sep 22.

Department of Emergency Medicine, Center for Experiential Learning and Simulation, University of Florida, 1104 Newell Drive, Suite 445, Gainesville, FL 32610, USA.

Surgeons can use simulation to improve the safety of the systems they work within, around, because of, and despite. Health care is a complex adaptive system that can never be completely knowable; simulation can expose aspects of patient care delivery that are not necessarily evident prospectively, during planning, or retrospectively, during investigations or audits. The constraints of patient care processes and adaptive capacity of health care providers may become most evident during simulations conducted "in situ" using real teams and real equipment, in actual patient care locations. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.005DOI Listing
February 2019

Patient Safety and Quality for Office-Based Procedures in Otolaryngology.

Authors:
Prerak D Shah

Otolaryngol Clin North Am 2019 Feb 22;52(1):89-102. Epub 2018 Sep 22.

New England Ear, Nose and Throat Center & Facial Plastic Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 198 Massachusetts Avenue, Suite 103, North Andover, MA 01845, USA.

Office-based procedures have increased in frequency with the recent changes in the current health care climate prioritizing improved efficiency and greater value in the care that is delivered. This article focuses on patient safety and quality issues that are specific to procedures in the office setting of an Otolaryngologist. Specific topics are categorized into preprocedure planning, procedural execution, and postprocedure follow-up. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183017
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http://dx.doi.org/10.1016/j.otc.2018.08.015DOI Listing
February 2019
2 Reads

Anesthesia Safety in Otolaryngology.

Otolaryngol Clin North Am 2019 Feb 22;52(1):63-73. Epub 2018 Sep 22.

Division of Pediatric Anesthesiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, 2200 Children's Way Suite 3116, Nashville, TN 37232, USA. Electronic address:

This article highlights the important relationship between the otolaryngologist and anesthesiologist, focusing on intraoperative patient safety for otolaryngologic surgery. In addition, consideration of preoperative history, physical examination, and potential postoperative complications helps guide the otolaryngologist and anesthesiologist in formulating an appropriate and collaborative management strategy. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.012DOI Listing
February 2019
1 Read

The Impact of Cognitive and Implicit Bias on Patient Safety and Quality.

Otolaryngol Clin North Am 2019 Feb 20;52(1):35-46. Epub 2018 Sep 20.

Bobby Alford Department of Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.

Humans use cognitive shortcuts, or heuristics, to quickly assess and respond to situations and data. When applied inappropriately, heuristics have the potential to redirect analysis of available information in consistent ways, creating systematic biases resulting in decision errors. Heuristics have greater effect in high-pressure, high-stakes decisions, particularly when dealing with incomplete information, in other words, daily medical and surgical practice. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.016DOI Listing
February 2019
1 Read

Device Safety.

Otolaryngol Clin North Am 2019 Feb 20;52(1):103-114. Epub 2018 Sep 20.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.

Medical devices are essential in the diagnosis and treatment of otolaryngologic disease. The US Food and Drug Administration (FDA) is tasked with assuring the safety and effectiveness of these devices. Otolaryngologists, in turn, are often responsible for helping patients understand risks, benefits, and alternatives when deciding whether to rely on devices in their care. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.013DOI Listing
February 2019

Systems Science: A Primer on High Reliability.

Otolaryngol Clin North Am 2019 Feb 20;52(1):1-9. Epub 2018 Sep 20.

Harvard Medical School, 1151 Beacon Street, Suite C1, Brookline, MA 02446, USA.

In the 21st century, most medical care is not delivered by a single physician but rather, by a team. A team is a type of system, a set of people and things interacting together for a defined aim. The discipline of systems science concerns itself with how complex teams or organizations function. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.001DOI Listing
February 2019
2 Reads

Preventing and Managing Operating Room Fires in Otolaryngology-Head and Neck Surgery.

Otolaryngol Clin North Am 2019 Feb 18;52(1):163-171. Epub 2018 Sep 18.

Department of Otolaryngology, Hofstra Northwell School of Medicine, Cohen Children's Medical Center, Northwell Health System, 269-01 76th Avenue, Queens, NY 11040 USA.

Otolaryngologists are at high risk of surgical fire. During surgery in the head and neck region there is close proximity of 3 essential elements: an ignition source, a fuel, and an oxidizing agent. In this article, the authors highlight the scenarios where fire may occur and offer steps that surgeons can take to minimize risk for their patients. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.011DOI Listing
February 2019
1 Read

Evaluation and Management of Facial Nerve Schwannoma.

Otolaryngol Clin North Am 2018 Dec 18;51(6):1179-1192. Epub 2018 Sep 18.

Department of Otolaryngology, Otology, Neurotology, and Skull Base Surgery, Harvard Medical School, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA.

Facial nerve schwannomas are benign peripheral nerve sheath tumors that arise from Schwann cells, and most commonly present with facial paresis and/or hearing loss. Computed tomography and MRI are critical to diagnosis. Management decisions are based on tumor size, facial function, and hearing status. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.013DOI Listing
December 2018
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Resident and Fellow Engagement in Safety and Quality.

Otolaryngol Clin North Am 2019 Feb 18;52(1):55-62. Epub 2018 Sep 18.

Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Division of Pediatric Otolaryngology, Children's Hospital of Wisconsin, 8915 W. Connell Court, Milwaukee, WI 53226, USA.

Beyond educational and institutional requirements, there is a need for trainees (residents and fellows) to learn patient safety and quality improvement skills in order to achieve the ultimate goal of providing better patient care. Key steps to engagement include creating a safety and quality culture, supporting faculty development, and selecting appropriate curricular resources. Efforts to align the goals and processes of the graduate medical education institution and teaching hospital can foster a unified mission. Read More

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http://dx.doi.org/10.1016/j.otc.2018.08.010DOI Listing
February 2019
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You're Never Fully Dressed Without a Smile.

Otolaryngol Clin North Am 2018 12 15;51(6):xv-xvi. Epub 2018 Sep 15.

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.2018.08.019DOI Listing
December 2018

Facial Palsy: Diagnostic and Therapeutic Management.

Otolaryngol Clin North Am 2018 12 15;51(6):xvii-xviii. Epub 2018 Sep 15.

Division of Facial Plastic & Reconstructive Surgery, Massachusetts Eye & Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

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http://dx.doi.org/10.1016/j.otc.2018.08.018DOI Listing
December 2018

Appreciating the Intricacies of a Stuffy Nose.

Otolaryngol Clin North Am 2018 10 7;51(5):xvii-xviii. Epub 2018 Jul 7.

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.2018.06.003DOI Listing
October 2018

Outcome Tracking in Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 29;51(6):1033-1050. Epub 2018 Aug 29.

Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.

Outcome tracking in facial palsy is multimodal, consisting of patient-reported outcome measures, clinician-graded scoring systems, objective assessment tools, and novel tools for layperson and spontaneity assessment. Patient-reported outcome measures are critical to understanding burden of disease in facial palsy and effects of interventions from the patient perspective. Clinician-graded scoring systems are inherently subjective and no 1 single system satisfies all needs. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183012
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http://dx.doi.org/10.1016/j.otc.2018.07.003DOI Listing
December 2018
7 Reads

Surgical Management of Acute Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 28;51(6):1077-1092. Epub 2018 Aug 28.

University of Iowa Hospitals and Clinics, 375 Newton Road, Iowa City, IA 52242, USA.

Bell palsy and traumatic facial nerve injury are two common causes of acute facial palsy. Most patients with Bell palsy recover favorably with medical therapy alone. However, those with complete paralysis (House-Brackmann 6/6), greater than 90% degeneration on electroneurography, and absent electromyography activity may benefit from surgical decompression via a middle cranial fossa (MCF) approach. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.005DOI Listing
December 2018
18 Reads

Surgical Management of Postparalysis Facial Palsy and Synkinesis.

Otolaryngol Clin North Am 2018 Dec 28;51(6):1169-1178. Epub 2018 Aug 28.

Department of Facial Plastic & Reconstructive Surgery, Center for Advanced Facial Plastic Surgery, 9401 Wilshire Boulevard, Suite 650, Beverly Hills, CA 90212, USA.

Modified selective neurectomy of the distal branches of the buccal, zygomatic, and cervical branches of the facial nerve in addition to platysmal myotomy is an effective surgical procedure for the treatment of postfacial paralysis synkinesis. Success of this procedure depends on identification of the peripheral facial nerve branches, preservation of zygomatic and marginal mandibular branches that innervate key smile muscles, and ablation of buccal and cervical branches that cause lateral and/or inferior excursion of the oral commissure. Results are long-lasting; objective improvements in electronic clinician-graded facial function scale score, House-Brackmann score, and decreased botulinum toxin-A requirements have been observed. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.012DOI Listing
December 2018
10 Reads

Management of Long-Standing Flaccid Facial Palsy: Periocular Considerations.

Otolaryngol Clin North Am 2018 Dec 28;51(6):1107-1118. Epub 2018 Aug 28.

Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

Ineffective eyelid closure can pose a serious risk of injury to the ocular surface and eye. In cases of eyelid paresis, systematic examination of the eye and ocular adnexa will direct appropriate interventions. Specifically, 4 distinct periorbital regions should be independently assessed: eyebrow, upper eyelid, ocular surface, and lower eyelid. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.007DOI Listing
December 2018
10 Reads

Management of Bilateral Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 27;51(6):1213-1226. Epub 2018 Aug 27.

Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address:

Bilateral facial paralysis is a rare entity that occurs in both pediatric and adult patients and can have congenital or acquired causes. When paralysis does not resolve with conservative or medical management, surgical intervention may be indicated. This article presents the authors' preferred technique for facial reanimation in patients with bilateral congenital facial paralysis. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.014DOI Listing
December 2018
9 Reads

Management of Long-Standing Flaccid Facial Palsy: Midface/Smile: Locoregional Muscle Transfer.

Otolaryngol Clin North Am 2018 Dec 24;51(6):1119-1128. Epub 2018 Aug 24.

Department of Otorhinolaryngology, The Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 48109, USA.

Masseter and temporalis muscle transfer is an effective technique for restoring facial symmetry and commissure excursion in flaccid facial paralysis. Adherence to the principles and biomechanics of muscle transfer is essential for achieving optimal results. Muscle transfer has the advantage of being single staged with fast recovery of function. 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.2018.07.008DOI Listing
December 2018
12 Reads

A General Approach to Facial Palsy.

Authors:
Nate Jowett

Otolaryngol Clin North Am 2018 Dec 16;51(6):1019-1031. Epub 2018 Aug 16.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

Management of facial palsy can be daunting. This article presents a conceptual framework for classification and therapeutic management of facial palsy. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.002DOI Listing
December 2018
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Free Gracilis Transfer and Static Facial Suspension for Midfacial Reanimation in Long-Standing Flaccid Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 10;51(6):1129-1139. Epub 2018 Aug 10.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.

This article presents an approach to reanimation of the midface in long-standing flaccid facial palsy by means of functional free gracilis transfer and static facial suspension. 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.2018.07.009DOI Listing
December 2018
9 Reads

The Importance and Psychology of Facial Expression.

Otolaryngol Clin North Am 2018 Dec 10;51(6):1011-1017. Epub 2018 Aug 10.

Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA.

Facial expression is of critical importance in interpersonal interactions. Thus, patients with impaired facial expression due to facial paralysis experience impaired social interactions. Numerous studies have shown that patients with facial paralysis and impaired facial expression suffer social consequences as demonstrated by being rated negatively with regards to attractiveness, affect display, and other traits. Read More

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http://dx.doi.org/10.1016/j.otc.2018.07.001DOI Listing
December 2018
1 Read