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Practice Focus

A Patient with Right-Sided Odynophagia

February 7, 2011

A 33-year-old white male presented with a one-year history of right-sided odynophagia. Symptoms were constant and exacerbated by swallowing. He had a history of cryptic tonsils but had not undergone tonsillectomy; his past medical history was otherwise unremarkable. There was tenderness to palpation over the right tonsil with exacerbation of symptoms. No head and neck masses were appreciated. A CT scan was obtained.

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Research Overhaul: Changes to cancer research organizations on the horizon, expert says

February 7, 2011

The system of clinical cancer research, including that of head and neck cancer, is in need of an overhaul, but steps are being taken that might lead to more efficient work and will hopefully mean more medical breakthroughs, said David Schuller, MD, the chair in cancer research at the Ohio State University College of Medicine in Columbus, at the Triological Society’s Combined Sections Meeting, held here on Jan. 27.

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Patient with Conductive Hearing Loss

January 14, 2011

A 71-year-old male presented with an approximately 10-year history of a gradually progressive right-sided hearing loss.

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Falling on Deaf Ears: Hearing loss in older adults may be an undertreated condition

January 10, 2011

Most people will experience some degree of hearing loss as they age. Statistics from the National Institute on Deafness and Other Communication Disorders at the National institutes of Health (NIH) indicate that 30 percent of adults ages 65 to 74, and 47 percent of adults 75 years or older, have hearing loss.

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Another Option for Allergic Rhinitis?: Study examines long-term safety, efficacy of RF turbinoplasty

January 10, 2011

When patients with allergic rhinitis don’t respond to medical therapy, an otolaryngologist’s arsenal of treatment includes surgical options. Among these is radiofrequency (RF) turbinate reduction, also known as RF turbinate ablation or turbinoplasty, an office procedure that advocates say is cost-effective and minimally invasive, with fewer complications than other surgical remedies. Some otolaryngologists, however, are still hesitant to use this relatively new therapy.

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A New Direction for Sleep: New OSA guidelines fuel another evidence-based medicine debate

December 1, 2010

Recent publication of practice parameters for surgery in adults with obstructive sleep apnea (OSA) by the American Academy of Sleep Medicine (AASM) has set off another round of debate on the need for otolaryngologists to get involved in generating their own guidelines. Although otolaryngologists have yet to agree on whether or not the time is right for guidelines on surgical treatment for sleep apnea, consensus can be claimed regarding the need perceived by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) to get on the evidence-based bandwagon.

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A Coping Mechanism: Child life specialists can ease hospital stays for pediatric patients

December 1, 2010

Seven-year-old Michael is scheduled to have a hemangioma removed from his face at the Arkansas Children’s Hospital (ACH) Ambulatory Surgery Center in Little Rock. The morning of surgery, he and his mother meet with child life specialists Cassandra C. James, MS, CCLS, and Camille Dante, MS, CCLS, who show him pictures of the operating room. They let him play with an anesthesia mask and a pulse oximeter, and talk about what to expect when he goes to sleep.

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Lingering Issues: Challenges remain in repairing CSF leaks

November 1, 2010

Once the province of neurosurgeons, cerebrospinal fluid (CSF) leak repair is now handled mostly by otolaryngologists. This change has occurred over the past couple of decades, during which time the evolution of endoscopic tools and techniques has made possible extracranial rather than intracranial repair. The success rate for repairing these leaks from below has reached about 90 percent, particularly for small leaks.

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Compliance Made Easy: High-tech systems remind patients to take their meds

November 1, 2010

Neil Chheda, MD, assistant professor of otolaryngology at the University of Florida in Gainesville, realized a few years ago that nearly half of his patients on proton pump inhibitors were taking them incorrectly.

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Old Problem, New Focus: Otolaryngologists tailor allergy treatments to geriatric patients

October 18, 2010

Allergic rhinitis among the elderly poses a particularly difficult diagnostic challenge for the otolaryngologist. As people age, they undergo immunosenescence. The thymus, which produces T cells against new invaders, atrophies markedly after adolescence, and this decline results in a less robust immune response to bacteria, viruses and presumably allergens (J Pathol. 2007;211(2):144-156). Consequently, physicians have assumed that allergies should decline as people age.

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