journal
Journals Otolaryngologic Clinics of Nor...

Otolaryngologic Clinics of North America

https://read.qxmd.com/read/38521722/pediatric-dysphagia
#21
REVIEW
Wade McClain, Jordan Luttrell, Elton Lambert
Pediatric dysphagia is a common condition encountered in clinical practice. We review the physiology and development of swallow, presentation, epidemiology, and etiology of dysphagia. Additionally, comorbidities, associated conditions, and medical management of dysphagia are discussed.
March 23, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38519293/advanced-diagnostic-techniques-in-obstructive-sleep-apnea
#22
REVIEW
Seckin O Ulualp, Eric J Kezirian
Optimal surgical and medical management of obstructive sleep apnea (OSA) requires clinically reliable identification of patterns and sites of upper airway obstruction. A wide variety of modalities has been used to evaluate upper airway obstruction. Drug-induced sleep endoscopy (DISE) and cine MRI are increasingly used to identify upper airway obstruction sites, to characterize airway obstruction patterns, to determine optimum medical and surgical treatment, and to plan individualized surgical management. Here, the authors provide an overview of the applications of DISE and cine MRI in assessing upper airway obstruction in children and adults with OSA...
March 21, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38519292/pediatric-esophageal-foreign-bodies-and-caustic-ingestions
#23
REVIEW
Kristina Powers, Cristina Baldassari, Jordyn Lucas
Foreign body ingestions commonly occur in children aged under 6 years. While serious complications of ingestions are rare, sharp objects, caustics, multiple magnets, and button batteries can be associated with poorer outcomes including gastrointestinal (GI) obstruction, perforation, necrosis, and fistula formation. Initial workup should include history, physical examination, and plain film radiographs that will identify radiopaque objects. Removal of the foreign body is typically warranted if the object is high risk, it is located higher up in the GI tract, the patient is symptomatic, or the object is retained for a prolonged amount of time...
March 21, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38508881/tracheostomy-related-swallowing-issues-in-children
#24
REVIEW
Eileen M Raynor, Daniel Wohl
Children with tracheostomies have multiple challenges with respect to achieving normal deglutition. These children may have underlying neurologic or genetic conditions that can predispose to dysphagia, but even in children without underlying comorbidities, the presence of a tracheostomy tube impacts the mechanics of swallowing, leading to difficulty with different consistencies as well as management of normal oral secretions. Intubation prior to tracheostomy also impacts sensation in the upper aerodigestive tract increasing the risk of aspiration...
March 19, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38503669/laryngeal-structural-dysphagia-in-children
#25
REVIEW
Allison Keane, Lauren K Leeper, Amelia F Drake
The upper aerodigestive system is closely intertwined from an embryologic and functional perspective. Laryngotracheal anatomic abnormalities, such as laryngomalacia, stenosis, vocal cord paralysis, and laryngeal clefts, affect not only the respiratory function but also the swallow function. Laryngotracheal pathology can interfere with the suck-swallow-breathe mechanism in infants. It can also exacerbate gastroesophageal reflux. Chronic aspiration secondary to laryngotracheal anomalies can result in respiratory and pulmonary complications...
March 18, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38503668/oral-structural-dysphagia-in-children
#26
REVIEW
Rose P Eapen, Amelia F Drake, Allison Keane
Oral causes of dysphagia in infancy may involve the lips, the tongue, or the palate. Whereas ankyloglossia is commonly diagnosed in infants with dysphagia, assessment of the need for surgical intervention may be less straightforward. Tongue size (macroglossia) may be associated with dysphagia as it may cause limitation of movement of the food or milk bolus by the lips or cheeks. Congenital conditions such as cleft lip and palate, micrognathia, or craniofacial microsomia may also be associated with dysphagia...
March 18, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38503667/nearly-200-years-of-sleep-apnea-we-ve-come-a-long-way
#27
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
March 18, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38485541/sex-differences-in-obstructive-sleep-apnea-including-pregnancy-and-response-to-treatment
#28
REVIEW
Taylor S Erickson, Megan L Durr
This article highlights the sex differences in obstructive sleep apnea (OSA) and sheds light on the varying presentations, diagnostic challenges, as well as treatment responses observed in men and women. The disparities in prevalence, manifestations, and therapeutic outcomes underscore the need for a nuanced approach to OSA diagnosis and management that considers sex-specific factors. Furthermore, this article highlights the importance of recognizing and treating OSA during pregnancy, as it poses unique challenges and potential risks to both maternal and fetal health...
March 13, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38485540/assessing-dysphagia-in-the-child
#29
REVIEW
Eileen Raynor, Jennifer Kern
Swallowing problems in children can occur for a variety of reasons, and assessment varies based on the age of the child, underlying medical problems, and results of the clinical swallow evaluation. The need for interdisciplinary management with speech language pathologists skilled in the management of children with dysphagia is imperative to identify the components of swallowing that are impaired and provide specific recommendations for safe and adequate nutrition supporting growth, development, and oral feeding if possible...
March 13, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38485539/dysphagia-in-head-and-neck-cancer
#30
REVIEW
Deepak Lakshmipathy, Melissa Allibone, Karthik Rajasekaran
Dysphagia is a common symptom in patients with head and neck cancer that can significantly impact health outcomes and quality of life. The origin of dysphagia in these patients is often multifactorial, making diagnosis and management especially complex. The evaluating otolaryngologist should be well versed with the patient's neoplasm, comorbidities, and treatment history alongside dysphagia-specific imaging modalities. Management is often dynamic, requiring frequent monitoring, interprofessional collaboration, and a variety of supportive and invasive measures to achieve optimal outcomes...
March 13, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38485538/advanced-diagnostic-techniques-in-obstructive-sleep-apnea
#31
REVIEW
Seckin O Ulualp, Eric J Kezirian
Optimal surgical and medical management of obstructive sleep apnea requires clinically reliable identification of patterns and sites of upper airway obstruction. A wide variety of modalities have been used to evaluate upper airway obstruction. Drug-induced sleep endoscopy (DISE) and cine MRI are increasingly used to identify upper airway obstruction sites, to characterize airway obstruction patterns, to determine optimum medical and surgical treatment, and to plan individualized surgical management. Here, we provide an overview of the applications of DISE and cine MRI in assessing upper airway obstruction in children and adults with obstructive sleep apnea...
March 13, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38485537/health-inequalities-in-the-diagnosis-and-treatment-of-obstructive-sleep-apnea-in-children-and-adults
#32
REVIEW
Javier J M Howard, Robson Capasso, Stacey L Ishman
Our understanding of the prevalence of obstructive sleep apnea (OSA) in the United States is confounded by significant inequalities in diagnosis and treatment based on gender, race and socioeconomic status. Health literacy and cultural norms contribute to these inequities. Large gaps in data exist, as certain populations like Native Americans, Pacific Islanders, and sexual minorities have been sparsely studied, or not at all. Future research should aim to develop more inclusive diagnostic strategies to address OSA in diverse populations...
March 13, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38458954/sleep-renewed-innovations-in-sleep-apnea-care-for-adults-and-children
#33
EDITORIAL
Reena Dhanda Patil, Stacey Ishman, Carol Li
No abstract text is available yet for this article.
March 8, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38458953/dysphagia-a-symphony-of-senses-at-the-ballet-takes-a-turn%C3%A2
#34
EDITORIAL
Mausumi Natalie Syamal, Eileen M Raynor
No abstract text is available yet for this article.
March 7, 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38508883/surgical-management-of-pediatric-obstructive-sleep-apnea-beyond-adenotonsillectomy-the-nose-nasopharynx-and-palate
#35
REVIEW
Nicholas R Lenze, Suhas R Bharadwaj, Christina M Baldassari, Erin M Kirkham
While adenotonsillectomy is the primary treatment of pediatric obstructive sleep apnea (OSA), persistent OSA after surgery is common and may be due to residual obstruction at the nose, nasopharynx, and/or palate. Comprehensive evaluation for persistent pediatric OSA ideally includes clinical examination (with or without awake nasal endosocpy) as well as drug-induced sleep endoscopy in order to accurately identify sources of residual obstruction. Depending on the site of obstruction, some of the surgical management options include submucous inferior turbinate resection, septoplasty, adenoidectomy, and expansion sphincter pharyngoplasty...
June 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38508882/neurostimulation-for-pediatric-obstructive-sleep-apnea
#36
REVIEW
Doug Chieffe, Christopher Hartnick
Up to 80% of children with Down syndrome (DS) are affected by obstructive sleep apnea (OSA), and only 16% to 30% will have resolution of their OSA with adenotonsillectomy. Hypoglossal nerve stimulation is a well-established therapy for adults with OSA and was recently approved by the Food and Drug Administration for use in children with DS and residual OSA. There is robust experience with this therapy in adults that has led to well-established care pathways. However, given the challenges inherent to caring for a complex pediatric population, these pathways are not directly transferrable to children with DS...
June 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38042667/home-sleep-testing-versus-traditional-polysomnography-pros-and-cons
#37
REVIEW
Beatrice C Go, Erica R Thaler
Obstructive sleep apnea (OSA) is associated with long-term cardiovascular and respiratory comorbidities and increased burden on the health-care system. Early and accurate diagnosis is essential to reduce physical and financial implications of the disease. Polysomnography uses neurophysiologic channels as well as basic respiratory and sleep parameters to best estimate the presence and/or severity of OSA. Although home sleep testing may have the potential for more variable results, it is a viable alternative to increase access to diagnosis of OSA and facilitate initiation of positive airway pressure...
June 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/38151386/interpretation-of-spirometry-peak-flow-and-provocation-testing-for-asthma
#38
REVIEW
Sukhmani Boparai, George M Solomon
Spirometry plays a crucial role in the diagnosis of asthma. The hallmark spirometry finding of expiratory airflow variability can be demonstrated in several ways including peak airflow and bronchodilator and bronchoprovocation testing. Challenges of overdiagnosis and underdiagnosis underscore the need to consider clinical context while interpreting these tests. A meticulous and multifaceted approach prioritizing objective testing is imperative while diagnosing asthma.
April 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/37951721/eosinophilic-esophagitis-what-the-otolaryngologist-needs-to-know
#39
REVIEW
Nainika Nanda, Dinesh Chhetri
Eosinophilic esophagitis is a male-predominant disease with presentations ranging from nonspecific feeding issues to dysphagia and food impaction. The currently proposed pathophysiology is a combination of genetics, allergens, and epithelial barrier impairment. Diagnosis is reliant on history, endoscopic examination, and biopsy. Recent guidelines recognize the role of concurrent gastroesophageal reflux disease. Treatment is based on 3 paradigms: diet, drugs, and dilation. Drug therapy has historically focused on topical corticosteroids; as of 2022, dupilumab was approved for targeted biologic therapy...
April 2024: Otolaryngologic Clinics of North America
https://read.qxmd.com/read/37923591/asthma-management-considerations-for-the-otolaryngologist-current-therapies
#40
REVIEW
Dhanya Asokumar, Amarbir S Gill
Asthma is frequently comorbid with chronic rhinosinusitis. First-line pharmacologic intervention for asthma includes combination-inhaled corticosteroids with a long-acting-β-agonist, preferably formoterol. Although short-acting-β-agonists have historically been used as sole rescue option, studies show that this approach can lead to more asthma-related exacerbations and greater mortality. Similarly, oral corticosteroids should be used sparingly due to their significant adverse effect profile. Nonpharmacological interventions for asthma include counseling on modifiable risk factors, such as smoking, physical activity, occupational exposures, and healthy diets...
April 2024: Otolaryngologic Clinics of North America
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