-
Ear, Nose, & Throat Journal Jul 2013It has been estimated that more than 50 million cases of dengue occur worldwide each year, mostly in the tropics. In light of recent cases appearing in central and... (Review)
Review
It has been estimated that more than 50 million cases of dengue occur worldwide each year, mostly in the tropics. In light of recent cases appearing in central and southern Florida, dengue has reemerged as a public health issue in the United States with respect to infection control and prevention. We review the course of dengue infection and its clinical presentation from the perspective of the practicing otolaryngologist, and we outline tactics for prevention and management.
Topics: Dengue; Disease Progression; Flavivirus; Humans
PubMed: 23904319
DOI: 10.1177/014556131309200713 -
American Journal of Rhinology & Allergy Jan 2021Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current... (Review)
Review
BACKGROUND
Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current Coronavirus Disease 2019 (COVID-19) pandemic highlights the devastating toll that respiratory viruses have on humanity and the desperate need to understand the biological characteristics that define them in order to develop efficacious treatments and vaccines. To date, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected nearly 600 times more people and resulted in 200 times more deaths relative to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) combined.
OBJECTIVE
Through this review, we aim to summarize the key characteristics of respiratory viruses that hold global significance, with a focus on SARS-CoV-2. Our goal is to disseminate our current knowledge of these infectious agents to otolaryngologists, in particular rhinologists, practicing in the COVID-19 era.
METHODS
The general and clinical characteristics of selected respiratory viruses along with available viral treatments and vaccines are reviewed.
RESULTS
There has been significant progress in our understanding of the epidemiology and pathogenesis of various respiratory viruses. However, despite the advancement in knowledge, efficacious vaccines and antiviral treatments remain elusive for most respiratory viruses. The dire need for these scientific discoveries is highlighted by the recent COVID-19 pandemic, which has prompted investigators worldwide to conduct clinical trials at an accelerated timeline in an effort to reduce the morbidity and mortality associated with SARS-CoV-2 infection. Rhinologists will continue to remain on the front-lines of pandemics associated with respiratory viruses.
CONCLUSION
In light of these unprecedented times, the need to understand the nuances of these viral respiratory pathogens, especially SARS-CoV-2, cannot be overemphasized. This knowledge base is of particular importance to otolaryngologists, whose expertise in the upper airway coincides with the anatomic tropism of these infectious agents.
Topics: Anti-Infective Agents, Local; Antiviral Agents; COVID-19; Disease Transmission, Infectious; Humans; Otolaryngologists; Practice Guidelines as Topic; Respiratory Tract Diseases; SARS-CoV-2; Viral Vaccines; Viruses; COVID-19 Drug Treatment
PubMed: 32762250
DOI: 10.1177/1945892420947929 -
Eye (London, England) Oct 2011To analyse the usefulness of a multidisciplinary facial function clinic (FFC). (Review)
Review
OBJECTIVES
To analyse the usefulness of a multidisciplinary facial function clinic (FFC).
DESIGN
Retrospective case-note review.
SETTING
The FFC was established in July 2006 at the Manchester Royal Eye Hospital with attending consultants from Ophthalmology, Skull-Base Otolaryngology, Plastic Surgery, and Physiotherapy.
PARTICIPANTS
We retrospectively reviewed the case notes for 59 consecutive patients seen at the FFC from July 2006 to February 2009.
MAIN OUTCOME MEASURES
We documented demographic data, including distance travelled and average journey time.
RESULTS
The 59 patients (mean age 46 years) made a total of 106 clinical visits (mean 1.8). The mean distance travelled by a patient was 31.9 miles with an estimated journey time of 47 min, each way. At presentation the average House-Brackmann grade of facial nerve weakness was IV. Ophthalmologist's advice was needed for 58 (98.3%), otolaryngologist's for 57 (96.6%), plastic surgeon for 49 (83.0%), physiotherapist for 58 (98.3%), and 4 (6.8%) were referred for psychological counselling. In all, 47 (79.7%) of our patients needed input from all four consultants during their visit at the FFC. By combining the presence of several consultants in one clinic, we saved an average of 5.1 visits (325.4 miles; 8 h travel time) for each patient.
CONCLUSION
We and our patients feel our multidisciplinary facial function clinic has been an effective service and has continued to work.
Topics: Adult; England; Facial Nerve Diseases; Female; Humans; Interdisciplinary Communication; Male; Middle Aged; Ophthalmology; Otolaryngology; Patient Care Team; Physical Therapists; Psychology; Referral and Consultation; Retrospective Studies; Surgery, Plastic; Treatment Outcome
PubMed: 21799520
DOI: 10.1038/eye.2011.183 -
Journal of Clinical Medicine Jan 2023Endodontic disease with formation of periapical lesions (PALs) is one of the most common causes of chronic odontogenic sinusitis (ODS). It requires close collaboration...
Endodontic disease with formation of periapical lesions (PALs) is one of the most common causes of chronic odontogenic sinusitis (ODS). It requires close collaboration between otolaryngologists and dentists, but the best sequence of management is still unknown. The aim of the present study is to clarify how radiological characteristics of teeth with PALs and previous root-canal treatment (RCT) influence the clinical evolution of the disease and to define the predictive value of its radiological and endoscopic features in determining the need for further surgical intervention. A total of 68 symptomatic patients with ODS with PALs were included in the study. The evaluation was performed by an otolaryngologist and a dentist based on a medical interview, nasal endoscopy, cold pulp testing and tomography images. Patients were prospectively followed for at least 12 months, during which nasal steroids, saline irrigations and RCT were administered. The criteria of disease improvement were: decrease of symptoms, healed sinonasal mucosa in endoscopy and radiological resolution of periapical radiolucency and sinus inflammation. Results showed that 9 (13%) patients improved after conservative treatment and 59 (87%) required further surgical intervention. Patients who improved after medical treatment and RCT were younger ( = 0.043) and had a greater distance from the top of the periapical lesion to the maxillary sinus' floor ( = 0.003). When expansion of PALs and bone destruction toward the maxillary sinus was observed on radiological imaging ( = 0.041), and when more than one tooth root was affected ( = 0.004), patients were more likely to require surgical intervention. In conclusion, the more roots that are affected and the closer the top of the PAL is to the maxillary sinus' floor, the greater the possibility of medical treatment and RCT failure. When the bone destruction extends into the maxillary sinus, patients eventually require both tooth extraction and FESS in order to resolve ODS completely.
PubMed: 36769751
DOI: 10.3390/jcm12031103 -
Indian Journal of Otolaryngology and... Oct 2022Vaccination against SARS CoV-2 has resulted in COVID-19 illness with reduced incidence and milder symptomatology. With the intent to analyze the olfactory and gustatory...
Vaccination against SARS CoV-2 has resulted in COVID-19 illness with reduced incidence and milder symptomatology. With the intent to analyze the olfactory and gustatory disturbances in breakthrough COVID-19 illness, we conducted a prospective observational study on a cohort of COVID-19 positive symptomatic otolaryngologist physicians. These doctors being well sensitized to the symptoms and signs of loss of smell and taste, reported even very mild and transient symptoms. This cohort of 25 physicians included 16 unvaccinated and 9 vaccinated otolaryngologists. The overall incidence of smell and taste disturbances reported in this cohort was 80% and 84% respectively. The incidence of olfactory dysfunction was 81% in the unvaccinated group and 78% in the vaccinated group. Similarly, the incidence of gustatory dysfunction was 81% in the unvaccinated group and 89% in the vaccinated group. However, the incidence of complete loss of smell was 54% in the unvaccinated group and 100% in the vaccinated group. Ageusia was noted in 15% of the unvaccinated physicians as compared to 25% of the vaccinated ones. The average duration of smell and taste loss were lesser in the physicians who were vaccinated with two doses than their unvaccinated counterparts. Larger studies are desirable to add further knowledge on the equal incidences and higher degree of loss of smell and taste observed in breakthrough COVID-19 illness as observed in our small prospective cohort study.
PubMed: 34849353
DOI: 10.1007/s12070-021-02998-8 -
American Journal of Otolaryngology 2020The COVID-19 pandemic has quickly and radically altered how Otolaryngologists provide patient care in the outpatient setting. Continuity of care with established... (Review)
Review
The COVID-19 pandemic has quickly and radically altered how Otolaryngologists provide patient care in the outpatient setting. Continuity of care with established patients as well as establishment of a professional relationship with new patients is challenging during this Public Health Emergency (PHE). Many geographic areas are under "stay at home" or "shelter in place" directives from state and local governments to avoid COVID-19 exposure risks. Medicare has recently allowed "broad flexibilities to furnish services using remote communications technology to avoid exposure risks to health care providers, patients, and the community." [1] The implementation of telemedicine, or virtual, services, will help the Otolaryngologists provide needed care to patients while mitigating the clinical and financial impact of the pandemic. The significant coding and billing issues related to implementing telemedicine services are discussed to promote acceptance of this technology by the practicing Otolaryngologist. Of particular importance, outpatient visit Current Procedural Terminology® codes (99201-99215) may be used for telehealth visits performed in real-time audio and video.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Female; Health Care Costs; Humans; Male; Medicare; Otolaryngologists; Otolaryngology; Outcome Assessment, Health Care; Pandemics; Pneumonia, Viral; Practice Patterns, Physicians'; Remote Consultation; SARS-CoV-2; Telemedicine; United States
PubMed: 32307192
DOI: 10.1016/j.amjoto.2020.102490 -
Journal of Medical Ethics and History... 2023To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a...
To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a comprehensive clinical education program for learners, along with specific ethical guidelines, and implementing managerial and executive interventions necessitates a thorough understanding of the ethical challenges within this field. This qualitative study aimed to elucidate the ethical issues faced by otolaryngologists. Sixteen otolaryngologists participated in the study, selected through purposive sampling. Data were gathered through semi-structured interviews, and the analysis, conducted through conventional content analysis, revealed eight main categories and 38 subcategories encapsulating the identified ethical issues. The primary categories encompassed ethical issues faced by otolaryngologists concerning patients and companions, education, communication with the treatment team, physicians' rights, medical tourism, medical advertising, cultural considerations, and managerial challenges. resources and treatment approaches in alignment with Iranian cultural norms, address conflicts between treatment and education, and implement sound management plans to uphold rights of the treatment team. Additionally, the study suggests the necessity of ethical advertising programs and the strategic promotion of therapeutic tourism.
PubMed: 38433813
DOI: 10.18502/jmehm.v16i18.14617 -
European Archives of... Nov 2021To identify complications of surgical tracheostomies in otorhinolaryngologic patients and adjust our processes to be properly prepared in the future.
PURPOSE
To identify complications of surgical tracheostomies in otorhinolaryngologic patients and adjust our processes to be properly prepared in the future.
METHODS
We reviewed retrospectively all surgical tracheostomies (n = 255) performed by otolaryngologist-head and neck surgeons at Helsinki University Hospital between Jan 2014 and Feb 2017. Patient demographics, surgical details, surgical and medical complications, and tracheostomy-related mortality were recorded from the hospital charts. Risk factors for complications were assessed.
RESULTS
Altogether, 55 (22%) complications were identified in 39 (15%) patients, with pneumonia, accidental decannulation, and bleeding being the most common. No patient or surgery-related factor reached significance in overall complication risk factor analysis. Medical complications were more common after elective tracheostomies compared to emergency procedures (10.6% vs. 3.5%, p < 0.05). Majority of complications (78%) were classified as mild or moderate according to Clavien-Dindo. Only 2 (0.8%) tracheostomy-related deaths were recorded.
CONCLUSION
In otorhinolaryngologists service, severe complications and tracheostomy-related deaths are very rare. Reducing their prevalence even further with careful planning is possible.
Topics: Humans; Otolaryngologists; Otolaryngology; Postoperative Complications; Retrospective Studies; Tracheostomy
PubMed: 33656585
DOI: 10.1007/s00405-021-06707-7 -
Otolaryngologic Clinics of North America Dec 1999With increased emphasis on early detection of hearing impairment, more babies are likely to be referred at younger ages to otolaryngologists for evaluation. With a... (Review)
Review
With increased emphasis on early detection of hearing impairment, more babies are likely to be referred at younger ages to otolaryngologists for evaluation. With a diminution in the number of infants who have hearing impairment as a result of such factors as maternal infection, neonatal sepsis, or ototoxicity, the relative importance of detecting a genetic cause of newborn hearing impairment is likely to increase. Therefore, the otolaryngologist must become familiar with common causes of hereditary hearing impairment and the ways in which the newborn should be evaluated for hereditary hearing impairment. Advancements are rapidly being made in the ability to detect genes that cause hearing impairment, and we are now on the threshold of discovering ways to use gene therapy to prevent or treat hereditary deafness.
Topics: DNA, Mitochondrial; Deafness; Gene Expression; Humans; Infant; Infant, Newborn; X Chromosome
PubMed: 10523453
DOI: 10.1016/s0030-6665(05)70195-x -
Breathe (Sheffield, England) Sep 2018While continuous positive airway pressure (CPAP) remains the gold standard treatment of choice in patients with moderate or severe obstructive sleep apnoea (OSA),... (Review)
Review
UNLABELLED
While continuous positive airway pressure (CPAP) remains the gold standard treatment of choice in patients with moderate or severe obstructive sleep apnoea (OSA), surgery has been established as a means to improve compliance and facilitate the use of CPAP, both of which are potential pitfalls in the efficacy of this treatment modality. In a minority of cases, with obvious oropharyngeal anatomical obstruction, corrective surgery may completely alleviate the need for CPAP treatment. In this review, we summarise clinical assessment, surgical options, discuss potential new treatments, and outline the importance of investigating and addressing the multiple anatomical levels that can contribute to OSA. Research into effectiveness of these procedures is rapidly accumulating, and surgery can be an effective treatment. However, given the myriad of options available and multiple levels of anatomical pathology that can present, it is imperative that correctly selected patients are matched with the most appropriate treatment for the best outcomes.
KEY POINTS
OSA is an increasingly prevalent disorder which has significant systemic effects if left untreated.Anatomical abnormalities can be corrected surgically to good effect with a growing and robust evidence base.Drug-induced sleep endoscopy is a key tool in the otolaryngologist's armamentarium to tailor specific surgery to address specific anatomical concerns, and to facilitate appropriate patient selection.Multilevel surgical approaches are often indicated instead of a "one size fits all" model.
EDUCATIONAL AIMS
To discuss how to assess patients presenting with OSA in clinic, from an otorhinolaryngology perspective.To discuss the indications for intervention.To provide an overview of nonsurgical interventions for treating OSA, with evidence.To discuss the different surgical modalities available for treatment of OSA, with evidence.
PubMed: 30364490
DOI: 10.1183/20734735.020118