Operative Techniques in Otolaryngology-Head and Neck Surgery (Operat Tech Otolaryngol Head Neck Surg )

Publisher: Elsevier

Description

This large-size, atlas-format journal presents detailed illustrations of new surgical procedures and techniques in otology, rhinology, laryngology, reconstructive head and neck surgery, and facial plastic surgery. Feature articles in each issue are related to a central theme by anatomic area or disease process. The journal will also often contain articles on complications, diagnosis, treatment or rehabilitation. New techniques that are non-operative are also featured.

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  • Website
    Operative Techniques in Otolaryngology - Head and Neck Surgery website
  • Other titles
    Operative techniques in otolaryngology--head and neck surgery
  • ISSN
    1043-1810
  • OCLC
    19336708
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details

Elsevier

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, arXiv.org or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Velopharyngeal insufficiency can be a post-operative sequel or congenital. Velopharyngeal insufficiency is defined as a degree of nasality that interferes with resonance quality and comprehensibility. The diagnosis and preoperative evaluation is contingent upon collaborative evaluation between the surgeon and speech language pathologist. A thorough history and a complete head and neck examination including a videotaped nasopharyngoscopy optimizes planning.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015;
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    ABSTRACT: For many individuals with hearing impairment the benefits of hearing aids may be reduced by acoustic feedback, occlusion effect, difficult fitting, and/or recurrent ear canal irritation. Additionally, many hearing aid candidates refuse use because of concerns over cosmetic appearance and the stigma associated with hearing aid use. Implantable hearing devices were developed to circumvent many of the limitations of conventional air conduction aids. The MAXUM system is a semi-implantable hearing device that amplifies sound via an implanted magnet attached to the ossicular chain, which is coupled to an electromagnetic driver located within the medial ear canal. The MAXUM system is based on the SOUNDTEC Direct System technology that initially received FDA approval in 2001. Outcomes with the SOUNDTEC Direct System have demonstrated enhanced functional gain, as well as reduced feedback and occlusion effect compared to hearing aids. Herein, we review the indications, surgical technique and outcomes of the MAXUM device.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 12/2014;
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    ABSTRACT: Cochlear implantation surgery has evolved over the past 30 years. Although the standard mastoidectomy with posterior tympanotomy has not change, recent techniques have focused on minimal incisions and hearing preservation. Evidence shows that smaller incisions with modest manipulation of soft tissue do not affect post-operative healing outcomes. There has been a trend advocating “soft-surgical” techniques in an attempt to preserve the cochlear sensory epithelium. However, the literature is inconclusive as to the outcomes of “soft-surgical” over standard techniques for hearing preservation including round window insertion and usage of adjuvants during insertion. Regardless of techniques, cochlear implantation remains an important therapeutic option for hearing loss.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 12/2014;
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    ABSTRACT: Bone conduction implantable devices are an effective means of rehabilitation for ipsilateral conductive hearing loss and in a CROS configuration for single-sided deafness. Percutaneous systems provide excellent sound quality but suffer from the complications of recurrent infection, skin overgrowth and cosmetic concerns. The Sophono transcutaneous bone conduction system uses an internal retention magnet to hold an external force plate and sound processor to the scalp allowing for transcutaneous bone conduction and stimulation of the cochlea. Implantation consists of a simple incision, drilling a shallow recess for the bi-lobed magnet in the cranium, and securing of the implant with standard plating screws. Surgical considerations such as placement, flush positioning to the bone, and maintaining or augmenting overlying tissue thickness are important to ensuring post-activation wearability. Fitting considerations such as time-to-fitting, magnet strength determination, and graduated wearing schedules are also critical to patient outcomes.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 12/2014;
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    ABSTRACT: Patients with Neurofibromatosis 2 (NF2) present complex and challenging management dilemmas. Surgical removal of vestibular schwannomas (VS) often result in total hearing loss. Early diagnosis using gadolinium-enhanced magnetic resonance imaging and refinements in hearing preservation surgery have improved our ability to prevent total hearing loss while achieving complete tumor removal in smaller tumors, but for patients with larger tumors or patients with no useful hearing in that ear, the auditory brainstem implant (ABI) allows restoration of some auditory function when the tumor is removed. Additionally, children with cochlear aplasia and cochlear nerve deficiency have begun to be implanted with auditory brainstem implants, with varied results. This article discusses surgical placement of the ABI.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 12/2014;
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    ABSTRACT: The parapharyngeal space (PPS) is an inverted cone shaped fascial space that extends from the skull base down to the level of the hyoid bone. Most tumors of the PPS are benign. Primary malignant tumors of the PPS are rare, and include minor salivary gland cancer, malignant peripheral nerve sheath tumors and malignant paragangliomas. Benign tumors of the PPS can be most often treated surgically by a transcervical or transparotid transcervical approach. A malignant PPS tumor often needs consideration for transmandibular access for adequate exposure and total surgical resection. Preoperative recognition of malignancy using appropriate imaging and if indicated, tissue diagnosis is therefore pivotal in successful operative planning, and oncologic, functional and cosmetic outcome. While the transmandibular approach provides excellent access to the PPS, accurate preoperative planning and meticulous surgical technique are crucial for successful outcome after mandibulotomy.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Parapharyngeal space infections (PPSI) often arise from pharyngeal or dental infections and, if left untreated, can result in serious complications ranging from mediastinitis to Lemierre syndrome to death. The parapharyngeal space is an inverted triangle spanning the skull base to the greater cornu of the hyoid, the inferior constrictor medially and the ramus of the mandible laterally with many vital structures contained within. Treatment begins with assessing the airway, considering the need for CT or MRI imaging with IV contrast and broad spectrum antibiotics. With evidence a PPSI has resulted in an abscess, there is failure of conservative management with 24 – 48 hours of IV antbiotics or in severe cases, surgical drainage is performed. This is done via the traditional transcervical route or, if the abscess is medial to the great vessels, a transoral approach. Complications of surgery are rare and resolution of symptoms with prompt antibiosis and surgical treatment prevent the possibility of infectious spread and its dangerous sequelae.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Deep lobe parotid gland and ectopic minor salivary gland tumors are the most common primary lesions found in the parapharyngeal space. Most deep lobe parotid tumors are pleomorphic adenomas and are usually contained within the parotid gland space but may expand into the prestyloid parapharyngeal space compartment. A transparotid approach is the preferred surgical method of extirpation of deep parotid lobe tumors, though it involves dissecting and transposing branches of the facial nerve to gain adequate access. In most cases of ectopic minor salivary gland tumors contained within the prestyloid parapharyngeal space, a transcervical approach is safe and offers excellent direct visualization of the tumor and all critical neurovascular structures. For large tumors involving the deep parotid lobe and extending into the prestyloid parapharyngeal space a combined transparotid/transcervical approach is usually warranted both to gain adequate access and to perform the surgery safely with limited morbidity.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Glumos Jugular paragangliomas are group of rare benign tumors originating from paraganglion cells of the parasympathetic nervous system and are usually hypervascular and slow-growing invading the temporal bone as they grow and may invade the intracranial space. Complete Surgical removal is the preferred treatment especially in young, health individual and has been reported to be achieved in up to 80% of patients. However, radiosurgery has become a valuable treatment option in small tumor, in elderly patient and as a complimentary treatment for surgery in large tumor invading the intracranial space. a complex transcranial skull base approaches arequiered for large tumor invading the middle and upper part of petrous bone, extending into the petroclival region and compressing the brainstem.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: The maxillary swing approach is an elegant and versatile technique designed to facilitate access to the nasopharynx and middle cranial fossa skull base. The approach involves the disassembly of the bony connections between the maxilla and the adjacent facial skeleton, leaving the maxillary infrastructure pedicled on its anterolateral soft tissue attachments. Excellent oncologic and functional outcomes have been reported in selected patient cohorts with recurrent nasopharyngeal carcinoma. Success depends upon respecting rigid criteria for patient selection, having a comprehensive understanding of skull base anatomy, and adhering to meticulous surgical technique and oncologic principles.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: The transcervical approach to the parapharyngeal space is the preferred approach for excision of parapharyngeal space masses. Limitations of this approach are overcome by the application of endoscopic visualization and dissection techniques. Primary indications for endoscopic assisted transcervical approach include salivary gland tumors, metastatic retropharyngeal lymphadenopathy and lateral extension of nasopharyngeal tumors. Endoscopy provides improved visualization with better resection margins and preservation of normal neural and vascular structures. Examples of applications of this approach are provided.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Parapharyngeal space tumors are routinely resected by a transcervical or transmandibular approaches. However, recent developments in techniques of trans oral robotic surgery (TORS) now allow the utility of the da Vinci robotic system for removal of parapharyngeal space tumors with minimal morbidity. In this paper we describe in details the setup and surgical technique of TORS for removal of large parapharyngeal tumors. TORS provides high magnification 3 dimensional visual access to lateral-based structures and enables direct visualization at and around the tumor. The 5-mm robotic guided arms enable an assistant to introduce additional instruments into the operating field to aid retraction, suction and cauterization. Robotic surgery is rapidly becoming integrated into transoral head and neck surgery. The utility of TORS improves the surgical removal of selected tumors in the parapharyngeal space with minimal morbidity and excellent functional and cosmetic outcomes.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Surgical management of tumors involving the infratemporal fossa can be technically challenging. Tumors not involving the petrous apex or the carotid artery can be safely and completely resected using a type 1, type 2 or type 3 dissection. The type of approach varies depending on involvement of surrounding anatomical structures. A type 1 dissection is adequate for tumors involving the maxillary sinuses, type 2 for tumors also involving ethmoid and sphenoid sinuses and type 3 for tumors involving the orbit. The aim of this review is to delineate the preoperative evaluation, surgical technique, intraoperative considerations and potential complications of these approaches to the infratemporal fossa.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives The purpose of this article is to provide a detailed explanation of the anatomical and technical considerations of the endoscopic, endonasal approach for the resection of schwannomas located in the retromaxillary space. Findings This approach often requires the establishment of a transmaxillary, transpterygoid corridor to reach the full extent of the retromaxillary space. Since schwannomas are often encapsulated, well-circumscribed, and peripherally attached to the parent nerve, complete resection is an achievable surgical goal. Although technically challenging, this minimally invasive approach to retromaxillary lesions minimizes facial incisions, displacement of normal tissue, and operative morbidity. Potential complications of the endoscopic approach include synechiae formation, trismus, vascular or nerve injury, and cerebrospinal fluid leak. Conclusion With a thorough knowledge of the operative technique and anatomical boundaries, the endoscopic, endonasal approach is a highly valuable surgical modality for the resection of retromaxillary schwannomas.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: The pterygopalatine fossa is a well-protected region of the skull base and surgical access for resection of tumors growing in this region can be challenging. Historically, the approach to this anatomic space has been an open transmaxillary technique. This results in disruption of the anterior and posterior walls of the maxillary sinus and numerous postoperative morbidities. More recently, improvements in endoscopic sinus surgery instrumentation and techniques have led to the advent of minimally invasive surgical approaches to the skull base. The use of endoscopes allows for improved visualization and surgical manipulation, as well as reduced postoperative comorbidities. We will discuss a graduated, minimally invasive approach to the pterygopalatine fossa.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: The parapharyngeal space is a deep fascial space in the suprahyoid neck, shaped like an inverted cone. The tensor vascular styloid fascia divides it into prestyloid compartment that mainly contains fat, and retrostyloid compartment that contains the carotid sheath and its content. Most lesions in the prestyloid parapharyngeal space either bulge into it from adjacent neck spaces or push it. The pattern of parapharyngeal fat displacement is used for localization of lesions in the deep neck. Primary lesions of the prestyloid parapharyngeal space are rare and mostly benign. Tumors of the retrostyloid compartment usually grow from the carotid sheath content and are mostly of neurogenic origin. Due to the central location of the space it may serve as a critical path of tumoral or infectious spread from one neck space to another. In this review we describe the basic anatomy of the parapharyngeal space and present the radiological approach to lesions involving it.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Tumours of the parapharyngeal space are rare. Due to absence of symptoms in early stages, they typically present at an advanced stage. Traditional transmandibular techniques of excision are associated with a high degree of morbidity, and low acceptance by patients for what is in most cases a benign condition. However, most of these tumours can be removed very elegantly via a transcervical approach, with minimal morbidity. The present paper presents our technique for transcervical removal of parapharyngeal tumours. Using this technique, the risk of complications is low, and oncological outcomes are excellent.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: Recurrent nasopharyngeal carcinoma (NPC) continues to be a problematic entity in terms of management. Treatment options include re-irradiation, open surgical resection, and more recently, endoscopic nasopharyngectomy. Patient selection is the most important factor when planning endoscopic approaches, and the surgeon must consider a variety of patient and disease factors. Generally speaking, most rT1, rT2, and some rT3 patients can be considered for endoscopic nasopharyngectomy. Although surgical techniques may vary, there are certain key elements common to all endoscopic approaches. With accurate patient selection and appropriate surgical execution, patients with recurrent NPC can be successfully managed endoscopically.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 09/2014;
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    ABSTRACT: This article discusses in detail the cultural aesthetic issues that confront the surgeon interested in performing Asian blepharoplasty in terms of defining an aesthetic Asian ideal and the subject of natural and ethnic preservation of identity. The surgical methodology of how to perform a full-incision-based Asian blepharoplasty is outlined in a stepwise fashion along with the perioperative concerns (preoperative planning and counseling, nature of recovery, and complications and revision surgery).
    Operative Techniques in Otolaryngology-Head and Neck Surgery 08/2014;
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    ABSTRACT: The inferior turbinate is an important structure serving a vital role in nasal physiology. However, inferior turbinate enlargement can lead to decreased nasal airflow and a sensation of nasal obstruction. Chronic nasal obstruction can substantially affect quality of life, productivity, and finances, and when medical therapies fail, surgical management is often recommended. Many techniques for inferior turbinate reduction exist, including outfracturing, submucosal soft tissue reduction (i.e., electrocautery, radiofrequency coblation, and powered microdebrider), submucosal bone removal, argon plasma coagulation, laser reduction, partial turbinectomy, and total turbinectomy. These techniques have demonstrated varied long-term results, and there remains a lack of consensus as to the optimal surgical technique. However, given the important role the inferior turbinates play in nasal physiology, many contemporary surgeons aim to strike a balance between adequate tissue resection for symptom improvement, and preservation of functional turbinate tissue and its contribution to normal nasal physiology.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 06/2014;