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Otolaryngologic Clinics of North America Oct 2022The endocannabinoid system is located throughout the central and peripheral nervous systems, endocrine system, gastrointestinal system, and within inflammatory cells.... (Review)
Review
The endocannabinoid system is located throughout the central and peripheral nervous systems, endocrine system, gastrointestinal system, and within inflammatory cells. The use of medical cannabinoids has been gaining traction as a viable treatment option for varying illnesses in recent years. Research is ongoing looking at the effect of cannabinoids for treatment of common otolaryngologic pathologies. This article identifies common otolaryngologic pathologies where cannabinoids may have benefit, discusses potential drawbacks to cannabinoid use, and suggests future directions for research in the application of medical cannabinoids.
Topics: Cannabinoids; Endocannabinoids; Humans; Otolaryngologists
PubMed: 36088164
DOI: 10.1016/j.otc.2022.06.012 -
JAMA Otolaryngology-- Head & Neck... Apr 2023There are many features of Down syndrome that prompt referral to an otolaryngologist. As the lifetime prevalence and life expectancy of individuals with Down syndrome... (Review)
Review
IMPORTANCE
There are many features of Down syndrome that prompt referral to an otolaryngologist. As the lifetime prevalence and life expectancy of individuals with Down syndrome increase, it is increasingly likely that otolaryngologists will have the opportunity to care for patients with Down syndrome.
OBSERVATIONS
A confluence of characteristics common to Down syndrome may be associated with issues in the head and neck, from infancy through adulthood. Hearing concerns range from narrow ear canals and cerumen impactions to eustachian tube dysfunction, middle ear effusion, cochlear malformations, and conductive, sensorineural, and/or mixed hearing loss. Immune deficiency, hypertrophy of Waldeyer ring, and hypoplastic sinuses may complicate and develop into chronic rhinosinusitis. Speech delay, obstructive sleep apnea, dysphagia, and airway anomalies are also common among this patient population. Because these concerns may necessitate otolaryngologic surgery, it is vital for otolaryngologists to familiarize themselves with anesthetic concerns, including cervical spine instability, in patients with Down syndrome. Comorbid cardiac disease, hypothyroidism, and obesity may also affect these patients and otolaryngologic care.
CONCLUSIONS AND RELEVANCE
Individuals with Down syndrome may visit otolaryngology practices at all ages. Otolaryngologists that familiarize themselves with the head and neck manifestations that are common among patients with Down syndrome and know when to order screening tests will be able to provide comprehensive care.
Topics: Humans; Down Syndrome; Otolaryngologists; Hearing Loss; Deafness; Otorhinolaryngologic Surgical Procedures
PubMed: 36862403
DOI: 10.1001/jamaoto.2023.0001 -
Otolaryngologic Clinics of North America Aug 2020Otolaryngologists are in a good position to advocate for our patients and our specialty. We can do it as a volunteer or as a full-time job running for political office... (Review)
Review
Otolaryngologists are in a good position to advocate for our patients and our specialty. We can do it as a volunteer or as a full-time job running for political office at the state or federal level. To be taken seriously, we need to offer solutions besides citing the problems. We encourage otolaryngologists to work with our Academy and its ENT-PAC (Ear, Nose, Throat Political Action Committee). Medicine is a great profession and Otolaryngology-Head and Neck Surgery is an even better specialty.
Topics: Health Care Reform; Humans; Leadership; Otolaryngologists; Otolaryngology; Practice Guidelines as Topic; Reimbursement, Incentive; Societies, Medical; United States
PubMed: 32381343
DOI: 10.1016/j.otc.2020.03.014 -
Otolaryngologic Clinics of North America Oct 2021Central vestibulopathies involve disorders of the central nervous system that lead to problems with balance, often manifested as dizziness, vertigo, and gait difficulty.... (Review)
Review
Central vestibulopathies involve disorders of the central nervous system that lead to problems with balance, often manifested as dizziness, vertigo, and gait difficulty. Central vestibulopathies can be distinguished from peripheral vestibulopathies with the use of certain tests, including nystagmography and posturography. The neuroanatomy of individuals with central vestibulopathies can reveal structural abnormalities in the posterior cerebrum or cerebellum. Various medications can be used to manage central vestibulopathies, including vestibular migraine.
Topics: Central Nervous System; Dizziness; Humans; Otolaryngologists; Vertigo
PubMed: 34538359
DOI: 10.1016/j.otc.2021.06.004 -
Otolaryngologic Clinics of North America Jun 2022Side-locked headaches are a common symptom having a wide-ranging differential. Unchanging in laterality, these headaches can represent neuralgias, trigeminal autonomic... (Review)
Review
Side-locked headaches are a common symptom having a wide-ranging differential. Unchanging in laterality, these headaches can represent neuralgias, trigeminal autonomic cephalgias, ophthalmologic disorders, otolaryngologic and craniofacial disorders, vascular disorders, and malignancy. In rarer situations, they have presented secondary to neurosurgical or dermatologic considerations. Loss of cranial nerves and visual changes warrant additional evaluation.
Topics: Headache; Humans; Otolaryngologists
PubMed: 35490038
DOI: 10.1016/j.otc.2022.02.008 -
Otolaryngologic Clinics of North America Jun 2022Headaches are a global health problem and are encountered by a variety of specialties, including otolaryngologists. These patients can present as a challenge, but an... (Review)
Review
Headaches are a global health problem and are encountered by a variety of specialties, including otolaryngologists. These patients can present as a challenge, but an understanding of primary and secondary headache disorders and the accompanying broad differential diagnosis is critical. For secondary headache disorders, a differential diagnosis categorized by anatomic location can help organize the evaluation of these patients, which can then be narrowed by the history and examination findings. Additional ancillary tests such as laboratories and imaging can further aid in diagnosis but are not always necessary.
Topics: Diagnosis, Differential; Diagnostic Imaging; Headache; Headache Disorders, Secondary; Humans; Otolaryngologists
PubMed: 35490037
DOI: 10.1016/j.otc.2022.02.001 -
Otolaryngologic Clinics of North America Jun 2022Idiopathic intracranial hypertension (IIH) is a triad of headaches, visual changes, and papilledema in the absence of a secondary cause for elevated intracranial... (Review)
Review
Idiopathic intracranial hypertension (IIH) is a triad of headaches, visual changes, and papilledema in the absence of a secondary cause for elevated intracranial pressure. There is an association with obesity, and the incidence is rising in parallel with the obesity epidemic. Sometimes these patients present to an otolaryngologist with complaints like tinnitus, dizziness, hearing loss, and otorrhea or rhinorrhea from cerebrospinal fluid leak. IIH diagnosis in conjunction with neurology and ophthalmology, including neuroimaging and lumbar puncture with opening pressure, is key to managing of this condition. Otolaryngologists should recognize IIH as a possible diagnosis and initiate appropriate referrals and treatment.
Topics: Humans; Intracranial Hypertension; Obesity; Otolaryngologists; Papilledema; Pseudotumor Cerebri
PubMed: 35490040
DOI: 10.1016/j.otc.2022.02.005 -
The Laryngoscope Nov 2020The SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), has rapidly swept across the world since its identification in December 2019. Otolaryngologists... (Review)
Review
The SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), has rapidly swept across the world since its identification in December 2019. Otolaryngologists are at unique risk due to the close contact with mucus membranes of the upper respiratory tract and have been among the most affected healthcare workers in Wuhan, China. We present information on COVID-19 management relevant to otolaryngologists on the frontlines of this pandemic and provide preliminary guidance based on practices implemented in China and other countries and practical strategies deployed at Stanford University. Laryngoscope, 130:2537-2543, 2020.
Topics: COVID-19; China; Disease Transmission, Infectious; Humans; Occupational Exposure; Otolaryngologists; Practice Guidelines as Topic; SARS-CoV-2
PubMed: 32219846
DOI: 10.1002/lary.28672 -
The Laryngoscope Jan 2020There is a narrow window of opportunity between surgical scheduling and the operative date to optimize patients for an elective surgical procedure. Traditionally,... (Review)
Review
There is a narrow window of opportunity between surgical scheduling and the operative date to optimize patients for an elective surgical procedure. Traditionally, preoperative care has involved extended routine testing batteries with intermittent referrals for medical clearance. These traditions are costly, inefficient, and yield no clear reduction in perioperative morbidity and mortality. Evidence, which has evolved over the past decade, suggests that optimal preoperative care requires a patient-centric, personalized, and often multidisciplinary approach. We present an up-to-date overview of this literature with a focus on the otolaryngologic surgical population. An algorithmic approach to preoperative patient assessment is also proposed in hopes of both optimizing patient outcome and streamlining routine clinical workflow. Laryngoscope, 130:38-44, 2020.
Topics: Appointments and Schedules; Elective Surgical Procedures; Evidence-Based Medicine; Humans; Otolaryngologists; Otorhinolaryngologic Diseases; Preoperative Care
PubMed: 30702154
DOI: 10.1002/lary.27845 -
Otolaryngologic Clinics of North America Jun 2022Patients will continue to present to the otolaryngologist's office with "sinus headaches" as their primary complaint. Otolaryngologists should take particular care in... (Review)
Review
Patients will continue to present to the otolaryngologist's office with "sinus headaches" as their primary complaint. Otolaryngologists should take particular care in establishing a precise diagnosis. A thorough clinical history, comprehensive head and neck examination, well-performed nasal endoscopy, and imaging as necessary are essential components for effective diagnosis and treatment plan implementation. It is fundamental to acknowledge the criteria for diagnosing the various headache disorders that may disguise themselves as sinonasal complaints. Moreover, this patient population accurately diagnosed and treated will be extremely grateful for someone pointing them in a direction to obtain the relief they truly need.
Topics: Diagnostic Imaging; Endoscopy; Headache; Humans; Otolaryngologists; Sinusitis
PubMed: 35680204
DOI: 10.1016/j.otc.2022.02.009