ENTtoday: February 2011

Treatment Options: Study reports neck dissection effective in patients with residual disease

Patients who had residual neck disease after treatment for a primary head and neck squamous carcinoma and then underwent neck dissection had comparable survival rates to those who had their disease resolved after their initial chemotherapy and radiation treatment, according to a retrospective analysis from researchers at the University of Louisville in Kentucky presented here Jan. 27.

A Clinical Challenge: Nasal valve compromise can be a dicey problem, panelists say

Problems with the nasal valve that lead to difficulty with breathing can be tricky, in terms of both diagnosis and treatment, said a group of experts here at the Triological Society’s Combined Sections Meeting on Jan. 28.

Tailored Treatments: The right approach to vocal fold paralysis depends on the patient, panelists say

Otolaryngologists treating vocal fold paralysis have many options from which to choose, but the best choice depends on the wants and needs of the patient, a panel of experts said here at the Triological Society’s Combined Sections Meeting on Jan. 28.

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

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.

A Glass Half Full: Triological Society president draws attention to the benefits of U.S. health care

The debate over soaring health care costs fails to properly acknowledge the benefits that have stemmed from improved medical technology and expanded medical knowledge, said Triological Society President Gerald Berke, MD, in an address at the society’s Combined Sections Meeting, held here on Jan. 27.

Lessons Learned: How to overcome the cultural barriers to EMR implementation

Health care reform and government incentives have intensified the dialogue on electronic medical records (EMR). Despite the financial incentives for EMR adoption included in the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, physician response remains lukewarm. The HITECH incentives program fails to recognize that the greatest barrier to EMR adoption is not financial, but cultural.

Tonsillectomy Revisited: New guidelines represent a clinical shift for some otolaryngologists

In its ongoing commitment to develop and practice evidence-based medicine, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recently issued a new clinical practice guideline on tonsillectomy in children.

A Patient with Right-Sided Odynophagia

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.

Nasopharyngeal Trumpet Serves as Direct Conduit in Fiberoptic Intubation

Is there a simple approach to facilitating fiberoptic intubation in the difficult airway? Background: Although fiberoptic intubation is one of the more successful and frequently utilized methods to access the difficult airway, it comes with challenges such as the presence of blood and secretions in the nasal and pharyngeal airways, edema from transoral attempts or anatomic […]

Large Study IDs Risk Factors for Hemorrhage After Tonsillectomy

What are the main risk factors associated with postoperative hemorrhage following tonsillectomy? Background: The most serious risk associated with tonsillectomy is postoperative hemorrhage, with previous reports linking it to operative technique. Many past studies, however, have been small or not well designed. Study design: Prospective multicenter observational study. Setting: Department of Otolaryngology, Head and Neck Surgery, University Hospital […]

Nasal Endoscopes May Cause Thermal Injury

What are the temperature variations of nasal endoscopes, and do older scopes reach higher temperatures? Background: Although advances in endoscopic technology have improved illumination and light transmission, there may be greater heat production that places patients at risk for thermal injury, especially when endoscopic equipment comes into direct contact with the tissue of otolaryngology patients. […]

Endoscopic Sinus Surgery Improves QoL in Patients with Minimal Disease

Will endoscopic sinus surgery (ESS) provide an improved quality of life (QoL) for patients with medically recalcitrant chronic rhinosinusitis (CRS) who have minimally affected computed tomography (CT) scans of the paranasal sinuses? Background: Although most otolaryngologists have encountered patients with symptoms and endoscopic findings suggestive of CRS, CT evaluation may demonstrate minimal mucosal disease in some […]

Patients Report Long-Term Benefits with Bone-Anchored Hearing Device

For the long-term use of a bone-anchored hearing device for single-sided deafness or profound unilateral sensorineural hearing loss (SNHL), what are the perceived benefits, complications and device malfunction rate? Background: For the condition of single-sided deafness or profound unilateral SNHL, there are limited rehabilitation options. These options include a CROS (contralateral routing of signals) hearing aid […]

High-Resolution CT and Diffusion-Weighted MRI Combo Improves Pediatric Cholesteatoma Detection

Does the technique of fusing MRI images with high-resolution CT images improve the efficiency of detecting recurrent cholesteatoma in children, in particular for small cholesteatomas? Background: Radiographic documentation of small recurrent cholesteatoma following pediatric middle ear/mastoid surgery or primary diagnosis of a small congenital cholesteatoma could provide benefit in the management decisions for these entities. Diffusion-weighted […]