Otolaryngologic Clinics of North America (Otolaryngol Clin)

Publications in this journal

• Article: Preface.

  Samuel S Becker
  Otolaryngologic Clinics of North America 05/2009; 42(2):xiii.
• Article: Disorders of swallowing: palliative care.

  Susan E Langmore, Gregory Grillone, Alphi Elackattu, Michael Walsh
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  ABSTRACT: This article defines palliative care for swallowing disorders as treatment for severe and chronic dysphagia or intractable aspiration when the recovery of normal swallowing is not anticipated and attempts to restore normal swallowing have been unsuccessful. Palliative treatment for dysphagia is not only for the dying patient because patients with difficulty swallowing can live for a long time. Palliative care for dysphagia is aimed at maximizing swallowing function, maintaining pulmonary health, and supporting healthy nutrition despite the impaired ability to swallow. When despite all attempts at intervention a patient becomes totally unable to swallow, the goal of therapy changes toward finding ways to provide adequate nutrition for the patient.
  Otolaryngologic Clinics of North America 03/2009; 42(1):87-105, ix.
• Article: Palliative treatment of dysphonia and dysarthria.

  Seth M Cohen, Alphi Elackattu, J Pieter Noordzij, Michael J Walsh, Susan E Langmore
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  ABSTRACT: The focus of this article is the palliative treatment of a variety of dysphonic conditions. Symptomatic relief of hoarseness can be achieved by voice therapy, augmentative alternative communication modalities, and surgery. The causes of dysphonia addressed herein include amyotrophic lateral sclerosis, Parkinson's disease, multiple sclerosis, stroke, head and neck cancers requiring glossectomy or laryngectomy, unilateral vocal fold paralysis, and presbyphonia. Palliative treatment of dysphonia and voice disorders provides symptomatic relief but not a cure of the underlying disease state. For these patients there are a number of palliative interventions that can greatly improve their quality of life.
  Otolaryngologic Clinics of North America 03/2009; 42(1):107-21, x.
• Article: Palliative aspects of recurrent respiratory papillomatosis.

  Kaalan Johnson, Craig Derkay
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  ABSTRACT: Recurrent respiratory papillomatosis (RRP) is a chronic, frequently debilitating, and potentially life-threatening disease. Therapy for RRP has evolved from simply inserting a tracheotomy to provide an airway and plucking out papillomata with cup forceps to provide some degree of voice to the present-day far more sophisticated approaches, along with preventative measures that may someday offer the potential dramatically to decrease disease prevalence. Family dynamics and support and intentional structuring of office protocols to accommodate the unique nature of RRP are as essential as any operative intervention for saving and prolonging life. This article reviews recent developments in the management of RRP and highlights palliative approaches to case management for those patients who are not easily cured with initial endoscopic interventions.
  Otolaryngologic Clinics of North America 03/2009; 42(1):57-70, viii.
• Article: Chronic subjective dizziness.

  Michael J Ruckenstein, Jeffrey P Staab
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  ABSTRACT: This article reviews the authors' work, which expands on previous studies to confirm that anxiety-related processes cause or maintain symptoms of dizziness. Discussed are interventions directed at patients' underlying psychologic disorders, including current methods of pharmacotherapy and psychotherapy. Patients with chronic complaints of nonspecific dizziness can present frustrating diagnostic and therapeutic challenges, but can be offered definitive and palliative care. The authors emphasize the importance of eliciting a precise description of the dizziness sensation from the patient as the critical factor in delineating the specific diagnosis and guiding treatment.
  Otolaryngologic Clinics of North America 03/2009; 42(1):71-7, ix.
• Article: Dedication.

  Ken Grundfast, Geoff Dunn
  Otolaryngologic Clinics of North America 03/2009; 42(1):xvii.
• Article: Alleviating head and neck pain.

  Abdel-Kader Mehio, Swapneel K Shah
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  ABSTRACT: Pain in patients who have cancer can be caused by direct effects of the tumor or by complications of treatment, or it can be unrelated to the disease or its treatment. This article discusses interventional pain procedures in the treatment of head and neck pain as they relate to malignancies and cervicogenic headache and neck pain.
  Otolaryngologic Clinics of North America 03/2009; 42(1):143-59, x.
• Article: Subjective idiopathic tinnitus and palliative care: a plan for diagnosis and treatment.

  Abraham Shulman, Barbara Goldstein
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  ABSTRACT: This article integrates the highlights of the authors' clinical experiences derived from existing protocols for tinnitus diagnosis and treatment with the evolving discipline of palliation medicine. Specifically, it demonstrates how the inclusion of principles of palliation medicine contributes to the efficacy of treatment.
  Otolaryngologic Clinics of North America 03/2009; 42(1):15-37, vii.
• Article: Living with head and neck cancer and coping with dying when treatments fail.

  Alphi Elackattu, Scharukh Jalisi
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  ABSTRACT: Palliative care in patients who have head and neck cancer is a complex topic that requires a multifaceted approach. The head and neck surgeon has an important duty to fulfill in managing and following the wishes of the incurable cancer patient and is obligated to direct them to the appropriate services in this challenging time.
  Otolaryngologic Clinics of North America 03/2009; 42(1):171-84, xi.
• Article: Principles and core competencies of surgical palliative care: an overview.

  Geoffrey P Dunn
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  ABSTRACT: The concept of palliation is as old as surgery itself, perhaps so old that it has been taken for granted rather than conceptualized as a primary framework for surgical care. The experience and success of the hospice movement in the United States and abroad was followed by the extension of its basic concepts to the much larger population of patients with advanced, but not necessarily terminal, illness. This collective experience has provided the necessary background and stimulus for developing a specific set of principles and competencies applicable to surgical palliative care. Surgical palliative care is the treatment of suffering and the promotion of quality of life for seriously or terminally ill patients under surgical care.
  Otolaryngologic Clinics of North America 03/2009; 42(1):1-13, vii.
• Article: Hearing loss.

  Alexa T Kozak, Kenneth M Grundfast
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  ABSTRACT: For physicians treating patients with sensorineural hearing loss, therapy is directed more toward helping the patient cope with the loss of hearing rather than offering various medical or surgical interventions. Accordingly, for the patient with sensorineural hearing loss, the care plan is usually more directed toward palliation than toward cure. This article views hearing loss not only as a physiologic deficit, but as the loss of an important aspect of overall communication skill that can have far reaching emotional and psychologic effects on the patient, the family, and those who surround patients in their daily lives. In this article the authors offer strategies for managing the patient who is losing or who has lost hearing.
  Otolaryngologic Clinics of North America 03/2009; 42(1):79-85, ix.
• Article: Anosmia: loss of smell in the elderly.

  Denis Lafreniere, Norman Mann
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  ABSTRACT: More than 35 million people in the United States are aged 65 years or older. Of people aged more than 80 years, 62% to 80% have a significant reduction in their sense of smell, which can adversely affect their safety and nutritional status. This article reviews the anatomy of smell and discusses the known and theorized etiologies of smell loss in the elderly population.
  Otolaryngologic Clinics of North America 03/2009; 42(1):123-31, x.
• Article: The role of vestibular rehabilitation in the balance disorder patient.

  Courtney D Hall, L Clarke Cox
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  ABSTRACT: The focus of this article is on the role of vestibular rehabilitation in the remediation of postural and gaze instability in individuals with peripheral vestibular deficits. Although vestibular rehabilitation does not cure the organic disease that produces the balance disorder, it improves mobility, prevents falls, and overall has a positive impact on the quality of life for the patient.
  Otolaryngologic Clinics of North America 03/2009; 42(1):161-9, xi.
• Article: Rehabilitation after cranial base surgery.

  Scharukh Jalisi, James L Netterville
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  ABSTRACT: Recent advancements in skull base surgery to remove or diminish the size of cranial base tumors allow more to be done than ever before to preserve life for patients who have tumors in anatomic locations once considered unreachable without causing massive functional impairment or death. Nonetheless, the resulting outcome has a direct and serious impact on the quality of life of the patient. In this article on palliation, the authors focus on the rehabilitative techniques used in patients who have undergone extensive cranial base resection. These techniques can also be used to improve the life of patients who have not undergone surgery but suffer from poor quality of life because of the natural growth of the tumor.
  Otolaryngologic Clinics of North America 03/2009; 42(1):49-56, viii.
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  Available from: cinac.org

  Article: Palliative care for the patient with refractory chronic rhinosinusitis.

  Elizabeth J Mahoney, Ralph Metson
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  ABSTRACT: Most otolaryngologists encounter patients with chronic rhinosinusitis who, despite conventional medical and surgical therapy, fail to show significant symptomatic improvement. Many paradigms have been proposed to explain the mechanisms responsible for refractory disease in these patients, including superantigen activation, biofilm formation, and eosinophil activation triggered by fungal elements. Although the precise underlying etiology of this clinical scenario remains unclear, the resultant pathophysiologic events share a final common pathway marked by inflammatory changes of the sinonasal mucosa. This article reviews the proposed hypotheses as to why some patients with chronic sinusitis fail conventional therapy and highlights treatment options useful in the palliative treatment of these patients.
  Otolaryngologic Clinics of North America 03/2009; 42(1):39-47, vii-viii.
• Article: A surgeon now board certified in palliative care.

  Geoffrey P Dunn
  Otolaryngologic Clinics of North America 03/2009; 42(1):xiv-xvi.
• Article: Tracheostomy in palliative care.

  Teresa Chan, Anand K Devaiah
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  ABSTRACT: The use of tracheostomy in palliative care offers a viable option for airway control. Through a dialogue with the patient, family, and a multidisciplinary set of providers, this procedure can be a useful component to a patient's overall palliative care plan. The authors discuss techniques for placing a tracheostomy tube and indications for placement in palliative care for alleviation of chronic and acute symptoms.
  Otolaryngologic Clinics of North America 03/2009; 42(1):133-41, x.
• Article: Imaging of recurrent thyroid cancer.

  Nafi Aygun
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  ABSTRACT: Recent improvements in serum Tg assays, the availability of recombinant thyrotropin, widespread use of neck ultrasonography, and positron emission tomography (PET)/CT have caused a shift of paradigm in the detection of recurrent disease in well differentiated thyroid cancer. High-resolution neck ultrasonography has taken on a central role, whereas (131)I whole body scanning has become less important. PET/CT has emerged as a powerful tool in the assessment of patients who have recurrent tumor not demonstrable with other imaging modalities. The author reviews the tools available for the detection and localization of recurrent thyroid cancer with respect to their advantages and limitations in various clinical scenarios.
  Otolaryngologic Clinics of North America 01/2009; 41(6):1095-106, viii.
• Article: Changes in surgical anatomy following thyroidectomy.

  Sara L Richer, Barry L Wenig
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  ABSTRACT: Thyroid reoperation is known to carry a higher risk for complications because of the increased challenge of identifying tissue planes, presence of adherent strap muscles, and generalized scarring of the thyroid bed. Consideration of postsurgical changes in the anatomy of important landmarks, such as the recurrent and superior laryngeal nerves, brachiocephalic artery, and parathyroid glands, is crucial during preoperative planning for thyroid reoperations. This article provides a review of these key changes in surgical anatomy and the implications of the anatomic changes after thyroidectomy.
  Otolaryngologic Clinics of North America 01/2009; 41(6):1069-78, vii.
• Article: Reoperative parathyroidectomy.

  Alfred Simental, Robert L Ferris
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  ABSTRACT: Reoperative surgery for hyperparathyroidism is associated with increased incidence of complications including vocal cord paralysis, permanent hypoparathyroidism, and persistent hypercalcemia. Surgical re-exploration should consist of symptomatic or low-risk patients. The use of nuclear medicine imaging, ultrasound, and high-resolution CT and MRI may aid in surgical planning. Knowledge of potential.
  Otolaryngologic Clinics of North America 01/2009; 41(6):1269-74, xii.