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

Publisher: WB Saunders

Journal 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.

Current impact factor: 0.00

Impact Factor Rankings

Additional details

5-year impact 0.00
Cited half-life 0.00
Immediacy index 0.00
Eigenfactor 0.00
Article influence 0.00
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

WB Saunders

  • 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 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 .
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    • 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
    • Authors who are required to deposit in subject-based repositories may also use Sponsorship Option
    • 'WB Saunders' is an imprint of 'Elsevier'
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of OSA in the general adult population is around 3-7% for men and 2-5% for women; however, variability in definitions may underestimate the true burden of the disease and postpone the treatment. Thus, the first step in the management of OSA is the accurate evaluation of the severity of the problem and also the level of obstruction. Different modalities such as clinical exam and videoendoscopy, have been used to detect OSA and its severity. But, the importance of these diagnostic tests is based on the specificity and the sensitivity of tests and their positive and negative predictive values. These tests are discussed in detail in this chapter.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 04/2015; DOI:10.1016/j.otot.2015.03.003
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    ABSTRACT: Obstructive sleep apnea, a common disease, is associated with increased morbidity and mortality. Patients with obstructive sleep apnea suffer from excessive daytime sleepiness, as well as an increased risk of cardiovascular disease. The cause is complex, involving many interacting factors that contribute to the pathogenesis of the disease. It is important to understand the anatomy and physiology of the upper airway, particularly what determines its stability and collapsibility.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.005
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    ABSTRACT: Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) often results from obstruction at multiple anatomic sites. Consideration of the complex relationship between sites of obstruction is paramount to choosing the correct surgical approach to treatment. Selection of patients that are likely to respond to surgery necessitates perioperative evaluation of individual patient anatomy. Surgical staging of OSAHS has been shown to be an accurate predictor of surgical success with UPPP, and can also be applied to predict patients who may be candidates for other treatments. We present our anatomic staging system and a grading system for lingual tonsil hypertrophy.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.007
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    ABSTRACT: Palatal surgery traditionally seeks to widen the airway, reducing obstruction of the tongue base, retropalatal, and lateral dimensions. Correction of the palate with the classical uvulopalatopharyngoplasty (UPPP), however, often results in a narrowed palatal arch. The Z-palatoplasty was first developed as a modification of the traditional UPPP, with the intent to widen the retropalatal space while maintaining or increasing the lateral space. Since its first description, the z-palatoplasty has been modified to include tonsillectomy and lateral pharyngoplasty. We describe the author’s technique and the evolution and successful application of the procedure.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.008
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    ABSTRACT: To review the literature on drug-induced sleep endoscopy (DISE) and summarize the key aspects of this procedure, which is done for patients with sleep-disordered breathing who are being considered for surgical treatment.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.004
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    ABSTRACT: Uvulopalatopharyngoplasty (UPPP) has been the most commonly performed procedure for obstructive sleep apnea. But high failure rates of this procedure that can reach 50% to 70% of the cases, has led to various modifications in UPPP technique to address persistent obstruction after traditional UPPP surgery. Expansion sphincteroplasty was developed as a modification of UPPP to address lateral wall collapse proximal to the free margin of the palate and transpalatal advancement pharyngoplasty was developed as a modification of UPPP to address more proximal anterior posterior narrowing of the retropalatal segment. Transpalatal advancement has also been shown to address proximal lateral wall airway narrowing.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.009
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    ABSTRACT: Pediatric obstructive sleep apnea is a multifactorial condition, with anatomic and neuromuscular components, significantly affecting the child’s quality of life and longterm health outcomes. Workup may include polysomnography, endoscopy and imaging to identify primary sites of obstruction. Adenotonsillectomy remains one of the first-line surgical options, with multiple modalities described. Palate and pharyngeal surgeries include lateral pharyngoplasty, modified expansion pharyngoplasty, and uvulopalatopharyngoplasty. Lingual tonsillectomy, midline posterior glossectomy, and tongue base suspension have been used to relieve the tongue base component of OSA. Laryngomalacia, whether congenital or occult in the older pediatric patient, may cause obstruction and necessitate supraglottoplasty with or without epiglottopexy. Syndromic patients, patients with craniofacial abnormalities, and patients with concomitant neurologic conditions often require multiple and more complex surgical interventions. Tracheostomy definitively relieves upper airway obstruction.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.010
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    ABSTRACT: The uvulopalatal flap was initially described by Powell and Riley in 1996 and has become a popular surgical option for treating obstructive sleep apnea. A number of advantages exist over the uvulopalatopharyngoplasty and these include reduced risk of velopharyngeal insufficiency and nasopharyngeal stenosis, potential to be reversible, improved velopalatal opening from preserved uvular muscle, low risk of bleeding, and reduced pain. An extensive preoperative workup should be performed to evaluate the patient, and the procedure is indicated in patients who demonstrate velopharyngeal obstruction and who are refractory to conservative medical management. Studies have confirmed that the uvulopalatal flap results in both objective and subjective improvements in obstructive sleep apnea. Complications are rare and typically minor. As a result, the uvulopaltal flap has become a popular option and the palatal procedure of choice for obstructive sleep apnea for many otolaryngologists.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.006
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    ABSTRACT: Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing. OSA is characterized by repetitive upper airway closure causing chronic intermittent hypoxia. The prevalence of OSA has significantly increased with the global epidemic in obesity. Despite the recognition of the serious health consequences of OSA, many patients with OSA remain underdiagnosed. This article provides a review of the epidemiology, the physiologic mechanisms, and the current non-surgical interventions for OSA.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2015; DOI:10.1016/j.otot.2015.03.002
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    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; DOI:10.1016/j.otot.2015.01.002
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    ABSTRACT: Lingual tonsillectomy and midline posterior glossectomy are useful in children with persistent obstructive sleep apnea following tonsillectomy and adenoidectomy who do not tolerate positive airway pressure ventilation. These techniques involve removing tissue from the surface (lingual tonsil) or base (midline posterior glossectomy) of the tongue to decrease bulk in the oropharynx. The aim of this review is to delineate the preoperative evaluation and intraoperative considerations of lingual tonsillectomy and midline posterior glossectomy in children.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.008
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    ABSTRACT: The management of Pierre Robin sequence is challenging and requires a multidisciplinary approach. A thorough workup must be done to exclude sites of airway obstruction other than the base of the tongue and to exclude central sleep apnea. Airway security is critical and can be managed non-operatively in the majority of children. When surgical management is necessary, the tongue-lip adhesion is the first step in many institutional algorithms. Multiple modifications have been described but the basic premise is an anterior advancement of the tongue base and suture fixation of the tongue to the lip. This increases the diameter of the airway and results in safe and successful management in the overwhelming majority of patients. There are few sequelae with the most common being dehiscence. This can be prevented by intermuscular sutures, a circummandibular stitch and release of the genioglossus muscle. Once mandibular “catch up” growth has been achieved, the tongue-lip adhesion may be reversed.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.009
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    ABSTRACT: Given the frequency with which operative intervention is undertaken in the pediatric oral cavity and oropharynx, knowledge of the anatomy is critical for all otolaryngologists. There are subtle, yet significant differences from adult oral anatomy that can affect the approach to operative intervention. Here we present pediatric oral anatomy as it pertains to operative approach and technique.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015;
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    ABSTRACT: Sialorrhea or drooling refers to the unintentional spillage of saliva from the oral cavity. Botulinum toxin injection into the salivary glands is a recognized clinically effective therapy for this condition. There are currently 4 botulinum toxin formulations available for clinical (off-label) use to improve sialorrhea: onabotulinumtoxinA (BOTOX®), incobotulinumtoxinA (Xeomin ®), abobotulinumtoxinA (Dysport®), and Rimabotulinum toxin B (Myobloc®). These should not be considered interchangeable.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.004
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    ABSTRACT: Ankyloglossia, while difficult to define and quantify, is present in approximately 4-5% of the pediatric population. Tongue-tie typically presents with difficulty breastfeeding due to reduced mobility of the tongue, and is implicated in difficulty with speech later in life. The lingual frenulum is typically a structure with low vascularity innervation, and amenable to surgical treatment in an outpatient clinic as well as the operating room. Multiple techniques from simple division to multiple-flap frenuloplasties have been developed to treat the disorder, and are tolerated well, with near immediate improvement in breastfeeding quality.
    Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.006
  • Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.007
  • Operative Techniques in Otolaryngology-Head and Neck Surgery 01/2015; DOI:10.1016/j.otot.2015.01.003
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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; DOI:10.1016/j.otot.2014.09.002
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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; DOI:10.1016/j.otot.2014.09.007
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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; DOI:10.1016/j.otot.2014.09.006