Abstract：
:There are two undeniable attributes of radiotherapy: its value in controlling head and neck malignancies and the progressive damage it inflicts on all treated tissues. It is fortunate that over the past decade, we have developed techniques and treatments that counteract, at least in part, the negative effects of radiotherapy on bone. Some of these measures are purely preventive and must be employed before or during radiation therapy to be successful. They include limiting the total radiation dose to less than 7000 Rads, appropriately shielding structures that do not require radiation, sparing one or more major salivary glands to minimize xerostomia, limiting fraction dosages to less than 200 Rads, obtaining pre-radiation dental evaluations, and performing dental extractions before radiotherapy begins. Additionally, treatments have been devised to prevent ORN following radiotherapy. They consist of patient participation in aggressive dental maintenance programs, oral fluoride treatments, and the use of preextraction hyperbaric oxygen when unhealthy teeth need to be removed. Should radiation-induced complications develop in spite of these efforts, treatments have been developed that effectively deal with ORN, namely, hyperbaric oxygen (the Marx protocol) and prolonged courses of intravenous antibiotics. Finally, when ORN results in mandibular loss and deformity, these defects can be effectively reconstructed with either corticocancellous particulate bone grafts or microvascular osseous tissue transfers, depending on the clinical situation. Much can be done to prevent and treat radiation-induced complications involving bone, and it remains the responsibility of the head and neck surgeon to make sure that these measures are utilized. When all priorities in treating ORN are considered, differentiating a radiation-induced wound healing problem from a delayed tumor recurrence remains paramount. This differentiation should always be the first step in the treatment of any radiation-induced wound.
journal_name
Otolaryngol Clin North Amjournal_title
Otolaryngologic clinics of North Americaauthors
Costantino PD,Friedman CD,Steinberg MJsubject
Has Abstractpub_date
1995-10-01 00:00:00pages
1021-38issue
5eissn
0030-6665issn
1557-8259journal_volume
28pub_type
杂志文章,评审abstract：:This article focuses on the rare and obscure complications of endoscopic sinus surgery. The majority of surgeons will not encounter these complications in their practice, but should be aware of their possibility. With knowledge of these rare complications, the surgeon can understand the possible avoidance as well as u...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2015.05.012
更新日期：2015-10-01 00:00:00
abstract：:Diet hypersensitivity may be "allergic," that is, caused by some form of immunologic reaction, or nonallergic. The latter includes chemical pharmacologic, enzymatic, or dietary disorders. Food allergies may be immediate Gell and Coombs type I reactions (5%), or delayed "serum sickness" type reactions (95%). The latter...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-02-01 00:00:00
abstract：:Medical management of Meniere's disease is successful in approximately 70% of patients. Surgical intervention is the treatment option when medication fails. Middle ear installation of aminoglycosides provides significant control of vertigo. This article addresses the role of aminoglycoside ablation of vestibular funct...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1997-12-01 00:00:00
abstract：:An understanding of the anatomy of the paranasal sinuses is essential for successful endoscopic sinus surgery. The anatomy of the sinuses is carefully described and illustrated. ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：:Craniofacial disassembly now plays a major role in the management of tumors that invade the skull base. The chief advantage of this technique is the greatly improved operative exposure it provides, allowing the surgeon to resect such tumors more completely and with an added margin of safety. Microneurosurgical advance...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：:This article is a comprehensive overview of tympanic membrane injury and its healing. Its wound healing process is unique from soft tissue because epithelialization occurs before fibrous tissue advancement. Contemporary and future modalities to improve tympanic membrane repair are also discussed in this article. ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-10-01 00:00:00
abstract：:As cochlear implant technology has changed, so have implantation criteria. In addition to profoundly deaf individuals, candidacy has expanded to include those with significant remaining acoustic hearing. This article describes the devices that are now in clinical trial, discusses the rationale as to why residual heari...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2011.09.001
更新日期：2012-02-01 00:00:00
abstract：:Since the description of a transnasal approach for treatment of pituitary tumors, transsphenoidal surgery has undergone continuous development. Hirsch developed a lateral endonasal approach before simplifying it to a transseptal approach. Cushing approached pituitary tumors using a transsphenoidal approach but transit...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2015.09.005
更新日期：2016-02-01 00:00:00
abstract：:Thyroid cancer is the most common endocrine malignancy and its incidence has increased over the past few decades. Most patients with thyroid cancer have an excellent prognosis, but there is a 15% recurrence rate within 10 years after initial treatment and mortality is possible. To date, there are no prospective, well-...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2014.04.010
更新日期：2014-08-01 00:00:00
abstract：:Facial nerve dysfunction after resection of a vestibular schwannoma is one of the most common indications for facial nerve habilitation. This article presents an overview of common and emerging management options for facial habilitation following resection of a vestibular schwannoma. Immediate and delayed nerve repair...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2011.12.015
更新日期：2012-04-01 00:00:00
abstract：:Nonsquamous cell tumors of the head and neck can be reliably identified and often accurately diagnosed by proper state of the art radiologic assessment. For optimal diagnostic and preoperative work-up of head and neck lesions, complete radiologic analysis is now essential. ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1986-08-01 00:00:00
abstract：:The term Meniere's disease is used to define either the classic triad of vestibular and cochlear symptoms and aural pressure from known or unknown causes or its clinical variants, vestibular and cochlear Meniere's disease. Some variants evolve after years into typical forms, whereas others do not. Some symptoms (posit...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0030-6665(02)00017-8
更新日期：2002-06-01 00:00:00
abstract：:Reconstruction of defects of the lip presents a significant challenge to the facial plastic surgeon. Both functional and aesthetic considerations exist. Each defect should be evaluated in terms of its location, size, and depth. Using these three factors, the appropriate reconstructive options can be chosen in a system...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1997-08-01 00:00:00
abstract：:Facial nerve paralysis in children should be considered distinct from that which occurs in adults. The author submits a slightly different classification of facial nerve paralysis in children based on traditional thinking. Specifically, acquired facial nerve paralysis is thought to be influenced by both prenatal and p...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:A patient seeking emergency treatment for a labyrinthine disorder is usually complaining of dizziness. The task at hand in the emergency room is, first, to rule out the truly life threatening emergent disorders, and then by means of a rapid but adequate history and physical examination to aid in the differentiation be...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：:Ultrasound, as a diagnostic modality, has been developing rapidly. High-resolution ultrasound machines have been reduced to the size of a laptop computer. Ultrasound can be adopted by otolaryngologists for use within the clinic and the operating room. Ultrasound offers several advantages to the pediatric patient popul...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：10.1016/j.otc.2010.08.010
更新日期：2010-12-01 00:00:00
abstract：:By using the quantification method for multidimensional qualitative data, 13 variables were analyzed. The younger the patient, the stronger was the correlation between age and positive glycerin and urea tests. At ages over 50 years no correlation with positive test results was found. The longer the duration of disease...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1983-02-01 00:00:00
abstract：:Polysomnography provides information on the physiological changes occurring in many different organ systems in relation to sleep stages and wakefulness. It allows qualitative and quantitative documentation of abnormalities of sleep and wakefulness, of sleep-wake transition, and of physiological function of other organ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2007.04.003
更新日期：2007-08-01 00:00:00
abstract：:The Sewall-Boyden flap, as used to reconstruct a frontal recess after frontoethmoidectomy, is conceptually similar to the endoscopic Lothrop procedure for surgical access to the frontal sinus. The operative technique, indications, and philosophy are presented in this article. ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0030-6665(05)70303-0
更新日期：2001-02-01 00:00:00
abstract：:The otolaryngologist will find in this article a direct and frank discussion and useful advice for how to get started performing solely endoscopic ear surgery for abnormalities of the middle ear. The author provides discussion and photos based on his experience with this procedure. Presented herein are selection of th...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2012.10.009
更新日期：2013-04-01 00:00:00
abstract：:Tracheal and laryngeal stenosis has become increasingly common following prolonged intubation or tracheostomy for mechanical ventilation and is directly related to trauma. Tracheal resection up to 4 to 5 cm. with an end to end anastomosis is the generally accepted treatment. However, tracheal resection carries the dan...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1979-11-01 00:00:00
abstract：:Bilateral vocal cord paralysis in children with its many causes presents a challenging problem to the pediatric otolaryngologist. Traditionally, management of bilateral vocal cord paralysis includes securing the airway with a tracheotomy and waiting for spontaneous recovery. Surgeons have tried a variety of surgical p...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2008.04.003
更新日期：2008-10-01 00:00:00
abstract：:The bipolar scissors, coblator, harmonic scalpel, and somnoplasty techniques are widely available and offer new choices for the operating arena. There are advantages and disadvantages to all four techniques. With time, these dissection methods will prove their lasting power. Otolaryngologists have already begun to exp...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2004.10.001
更新日期：2005-04-01 00:00:00
abstract：:The technique which should be used for pediatric tracheotomy is controversial. The literature is reviewed regarding animal and human data, and our experience at Henry Ford Hospital with the flap technique is reported. Flap tracheotomy is believed to be a safe technique in children. ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:Pharmacologic labyrinthectomy has become an alternative to surgery for treatment of severe Ménièr's disease. The use of systemic streptomycin has been replaced by intratympanal instillations of gentamicin that are administered once daily for a limited number of days. Gentamicin provides a high success rate for ablatio...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1994-04-01 00:00:00
abstract：:Otosclerosis surgery is performed through a transcanal approach and requires long, thin instruments with submillimetric precision and precise amplitude of motion. The functional outcomes and complications of otosclerosis surgery depend on the experience of the surgeon. Thus, any technological assistance that can enhan...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2017.11.016
更新日期：2018-04-01 00:00:00
abstract：:The saddle nose and short nose deformities are challenging surgical problems characterized by significant architectural deficiencies of the nasal framework. These defects produce cosmetic and functional nasal problems. Reconstructive techniques and augmentation materials are reviewed. Case examples illustrate the auth...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：10.1016/s0030-6665(05)70117-1
更新日期：1999-02-01 00:00:00
abstract：:Inner ear medical therapy has been gaining increasing popularity during the last 2 decades. Despite the increased use of this therapy,basic questions regarding this type of treatment have not been answered. The authors have used a variety of sustained-release devices in the laboratory to begin to answer some of these ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2004.04.005
更新日期：2004-10-01 00:00:00
abstract：:After nearly a century of performing thyroidectomy essentially the way it was described by Theodore Kocher in the nineteenth century, the technique has quickly evolved. Parathyroidectomy has advanced as biochemical assays and physiologic imaging have become available. Minimally invasive and endoscopic thyroidectomy an...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.otc.2010.02.005
更新日期：2010-04-01 00:00:00
abstract：:This article has presented suturing techniques and instrumentation and suggestions that we have found to be helpful in the management of facial soft tissue injuries. The reader is encouraged to practice suture and knot tying techniques on fresh pigfeet, which are readily accessible and inexpensive and approximate the ...
journal_title：Otolaryngologic clinics of North America
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
