Six years after balloon sinuplasty was introduced to the otolaryngology community, it remains an evolving technology. “In my opinion, balloon dilatation has great potential, but it’s still trying to find its proper place in the ENT arena,” said Ralph Metson, MD, clinical professor of otology and laryngology at Harvard Medical School and Massachusetts Eye and Ear Infirmary in Boston.
Departments » Special Reports
One of William Dale’s healthiest patients was working out three times a week, regularly walking two miles, lifting weights, maintaining a stable body weight of 120 pounds and not on any medications when she was diagnosed with a stage IV ovarian cancer. Dale, MD, PhD, section chief of geriatrics and palliative medicine at the University of Chicago, said the patient did fine with both surgery and chemotherapy. The fact that she was 89 years old, he said, shouldn’t necessarily come as a surprise.
Fat grafts have been used to repair the aging face for about two decades, but recently, surgeons have been using grafts to repair more extensive facial deformities caused by injury, illness or congenital abnormalities. Success, they said in interviews with ENT Today, depends on proper patient selection, matching the fat graft to defects that are most amenable to repair with fat injections and an understanding of the biology of the graft and how it reacts with surrounding facial structures.
For patients who undergo septoplasty to repair a crooked septum, reconnecting pieces of cartilage and stabilizing the cartilage during the healing process is critical to achieving straight alignment of the nasal septum. Stabilizing cartilage is particularly challenging for patients who require correction of severe septal deviations or severe post-traumatic deformities that are often both functional and cosmetic.
Since the first report in 2008 of the effectiveness of propranolol to treat infantile hemangiomas, its use has grown among physicians who treat these tumors, which arise in 5 to 10 percent of infants. Among these infants, approximately 10 percent will require treatment to correct functional impairment or prevent lasting cosmetic deformity caused by the hemangioma.
Physicians have noted the potential for dizziness in migraine patients since the 19th century. And yet the 21st century has so far failed to bring any unifying definition to a symptom that is frustratingly diffuse in its intensity and frequency and unclear in its origins.
For decades, otolaryngologists have been frustrated by the refusal of some patients with hearing loss to use hearing aids. Statistics on noncompliance vary, but there is general agreement that only about 20 percent to 25 percent of Americans with treatable hearing loss use hearing aids. The problem seems to be more acute for people with mild hearing loss: A consumer survey conducted by the nonprofit Better Hearing Institute in 2009 found that fewer than 10 percent of people with mild hearing loss use amplification and that even among people with moderate-to-severe hearing loss, only four in 10 use amplification.
When it comes to treating head and neck tumors, the more information that is available, the better. In the past, options for investigating these types of tumors and their aggressiveness were limited. But advances in optical imaging, positron emission tomography (PET) scanning, magnetic resonance imaging (MRI) and fluorescent and ultrasound imaging have some otolaryngologists excited about the prospect of getting a better look at head and neck cancer.
Since the advent of the cochlear implant more than 20 years ago, the devices have benefited thousands of patients. According to the U.S. Food and Drug Administration, as of April 2009, approximately 188,000 people worldwide have received cochlear implants. In the U.S., about 42,000 adults and 26,000 children have received them. Today, the fantasy of two implanted artificial cochlea is a reality.