Abstract:
:The lacrimal drainage system is a very important functional and anatomic assembly in the orbit and midface. For surgeons who intend to become involved in its repair or reconstruction, it is mandatory to understand the full range of anatomic, physiologic, and diagnostic considerations prior to embarking upon a surgical course. Proper eyelid function depends upon the integrity of its constituent parts, including the margin, tarsus, muscle, and globe apposition. The lacrimal pump mechanism is produced by proper eyelid function and structure, and must be adequately assessed. The puncta and canaliculi are delicate structures and must be manipulated with care and gentleness. The lacrimal sac is a static structure that serves as a collecting sphere but also may be forced to evacuate its contents into the nasolacrimal duct by the "squeezing" action of the investing tendons. Proper tendon position must be maintained after surgery or trauma to facilitate this action. The nasolacrimal sac may be damaged after facial fractures or blocked from intranasal conditions. If the blockage cannot be relieved, it must be bypassed by performing a dacryocystorhinostomy. The use of long-term, indwelling silicone intubation catheters greatly facilitates the successful reconstruction of the lacrimal drainage system. Proper attention to all of these points will be appreciated by the patient.
journal_name
Otolaryngol Clin North Amjournal_title
Otolaryngologic clinics of North Americaauthors
Holt JE,Holt GRsubject
Has Abstractpub_date
1988-02-01 00:00:00pages
119-34issue
1eissn
0030-6665issn
1557-8259journal_volume
21pub_type
杂志文章,评审abstract::This article presents a summary of the current simulation training for otologic skills. There is a wide variety of educational approaches, assessment tools, and simulators in use, including simple low-cost task trainers to complex computer-based virtual reality systems. A systematic approach to otologic skills trainin...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2017.05.005
更新日期:2017-10-01 00:00:00
abstract::There are several advances in diagnosis and management for the otolaryngologist treating allergy. These include new technologies and the refinement of current techniques, and reflect overall trends in health care toward personalized medicine. Local immunoglobulin, urinary leukotriene E4, lipidomics, microRNA within ex...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2017.08.014
更新日期:2017-12-01 00:00:00
abstract::Endoscopic pituitary surgery has been gaining wide acceptance as the first-line treatment of most functional pituitary adenomas. This technique has many advantages over traditional procedures, and growing evidence supports its use for endocrine control of functioning tumors. This article reviews data on the different ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2011.06.019
更新日期:2011-08-01 00:00:00
abstract::The role of cryosurgery in the treatment of tonsil disease is an unresolved issue. Initial favorable reports failed to provide the necessary incentives for larger well-controlled studies. Bacteriologic and immunologic response to the cryosurgical treatment of tonsils remains unclear. Without appropriate studies, cryos...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::Humans use cognitive shortcuts, or heuristics, to quickly assess and respond to situations and data. When applied inappropriately, heuristics have the potential to redirect analysis of available information in consistent ways, creating systematic biases resulting in decision errors. Heuristics have greater effect in h...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2018.08.016
更新日期:2019-02-01 00:00:00
abstract::This article outlines the historical development of the use of lasers in the tracheobronchial tree, the current indications for the use of carbon dioxide and neodymium:yttrium-aluminum-garnet lasers, and the management of complications. The merits of other laser wavelengths are mentioned, including use of the potassiu...
journal_title:Otolaryngologic clinics of North America
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::A wide range of reconstructive options allows the ablative surgeon to resect tumors completely with wide margins. Wide resection is especially important because of the rich lymphatic drainage and submucosal spread seen with carcinomas in the hypopharyngeal area. Postoperative stenosis can be a difficult, recurring pro...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0030-6665(02)00034-8
更新日期:2002-10-01 00:00:00
abstract::The actinic keratotic lesion appearing on the sun-exposed skin of the middle-aged and elderly is a common premalignant lesion that infrequently becomes squamous cell carcinoma. Generally, superficially destructive measures provide adequate therapy for this epidermal dysplastic growth. Because of the rare threat of squ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::The most frequently encountered complications in the treatment of laryngeal cancer are discussed. Preoperative and surgical problems and complications encountered secondary to radiation and chemotherapy are included, along with airway obstruction, failure to diagnose, pharyngocutaneous fistula, stomal stenosis, and po...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1997-04-01 00:00:00
abstract::Six atypical case presentations of parotid tumors are presented along with solutions proposed by two experts on the topic. The differences and similarities of the opinions expressed are summarized and discussed by the editor. ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::The allergic march is a progression of atopic disease from eczema to asthma, and then to allergic rhinoconjunctivitis. It appears to be caused by a regional allergic response with breakdown of the local epithelial barrier that initiates systemic allergic inflammation. Genetic and environmental factors predispose to de...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2011.03.006
更新日期:2011-06-01 00:00:00
abstract::Thyroid cancer represents the most common endocrine cancer, and rates have been increasing over the last 3 decades. The treatment of cervical metastases in well differentiated thyroid cancer remains in evolution. Many questions require further resolution. Unlike many other malignancies, most large studies have found t...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2008.06.002
更新日期:2008-12-01 00:00:00
abstract::Rational antibiotic therapy for sinusitis is a difficult goal, made difficult by few satisfactory comparative trials with sufficient clinical power, the large numbers of therapeutic options, prescribing pressures from the pharmaceutical industry, and rapid changes in bacterial resistance patterns. Controversies exist ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1997-06-01 00:00:00
abstract::Although many patients with hearing loss benefit from medical or surgical intervention, the vast majority have noncorrectable hearing disorders for which rehabilitation through amplification is indicated. There are three goals for the application of hearing aids: (1) to amplify normal conversational speech to levels t...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::Community noise is reported to be the most often mentioned undesirable neighborhood condition in a recent U.S. Census survey. Understanding community response to noise involves the measurement of a number of complex acoustic and nonacoustic variables and establishing the chain of relationships between physical exposur...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1979-08-01 00:00:00
abstract::Obstructive sleep-disordered breathing consists of a spectrum ranging from the upper airway resistance syndrome to complete apnea. Although this disorder is relatively common, it is still under-recognized, resulting in a significant increase in morbidity and mortality. This article describes the rationale for treating...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:10.1016/s0030-6665(05)70133-x
更新日期:1999-04-01 00:00:00
abstract::Specific deficits that may be encountered as well as interventional strategies and evidence-based practice are discussed. When discussing the voice, it is important to consider that for many people the voice is not just a tool for communication, but also an identifying feature that allows expression of personality. Ea...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2008.01.018
更新日期:2008-08-01 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::Serous otitis media is the most common health problem in children receiving nonsurgical and surgical medical treatment. Spontaneous remission frequently occurs, thus an expectant wait-and-see approach is initially appropriate. ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::Minimally invasive sinus technique (MIST) is a targeted endoscopic intervention, introduced in 1994, with goals virtually identical to those originally reported for FESS but with distinct differences. The procedure, as outlined in the following section, is the only stepwise intranasal intervention with a defined begin...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/S0030-6665(03)00156-7
更新日期:2004-04-01 00:00:00
abstract::Patients with dizziness and psychopathology present diagnostic and therapeutic challenges to clinicians in several specialties. Clinical research is beginning to define the medical-psychiatric interactions that produce many of these patients' symptoms. Treatment research is still in its infancy. A model of illness pro...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0030-6665(05)70230-9
更新日期:2000-06-01 00:00:00
abstract::Balloon catheter dilation (BCD) is a treatment paradigm for surgical management of paranasal sinus inflammatory disease. There are few robust clinical trials evaluating the efficacy of balloon technology in chronic rhinosinusitis (CRS). The available database largely comprises retrospective, uncontrolled studies with ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2012.06.005
更新日期:2012-10-01 00:00:00
abstract::Thyroid tumors in children continue to generate tremendous interest and controversy. Despite a frequent presentation with metastatic disease, these differentiated tumors have an excellent prognosis. Because most pediatric patients have prolonged survival, long-term follow-up is mandatory. The extent of surgery for thi...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1996-08-01 00:00:00
abstract::The best management of advanced head and neck tumors invading the carotid artery utilizes a collaborative, anticipatory approach. Preoperative characterization of the anatomy and extent of tumor involvement, coupled with the physiologic assessment of the cerebrovascular circulation through the variety of adjunctive st...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Objective measurement of vocal function, e.g., acoustical analysis, is emerging as a necessity in clinical practice. Voice data assist in determining the diagnosis and prognosis of many voice disorder patients and provide documentation of the vocal quality before, during, and after treatment. ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::With fiber-based lasers that may be passed via the working channel of a flexible laryngoscope, in-office laser laryngeal surgery has become possible. The potassium-titanyl-phosphate laser has several features that make it ideal for laryngeal surgery, and it is now the laser of choice for in-office management of a vari...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2019.02.011
更新日期:2019-06-01 00:00:00
abstract::Cholesteatomas (epidermoids) of the middle ear appearing medial to a normal tympanic membrane are identified in increasing numbers of young children. The evidence that these lesions are congenital in origin includes the young mean age of presentation, the normal appearance of the middle ear mucosa in almost all cases ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-10-01 00:00:00
abstract::Sleep-related symptoms are extremely common in patients with allergic rhinitis. Sleep impairment is likely a major contributor to the overall disease morbidity, direct and indirect health care costs, and the loss of work productivity associated with allergic rhinitis. The association between allergic rhinitis and slee...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2011.03.020
更新日期:2011-06-01 00:00:00
abstract::The nose occupies an important feature of a person's central face. The size, shape, and proportions of the various characteristics of the face provide a visual basis suggesting the character of the person. Scars, asymmetries, and any abnormalities of the central face are easily recognizable and noted by even a casual ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:10.1016/s0030-6665(05)70013-x
更新日期:2001-08-01 00:00:00
abstract::We believe that it is essential to closely monitor the viability of any free flap in order to decrease potential morbidity to the patient. A myriad of techniques have been described, many of which appear quite promising; none has been widely accepted. We believe that clinical assessment of an exposed portion of a free...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00