Otolaryngologic clinics of North America
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Facial trauma in children differs from adults. The growing facial skeleton presents several challenges to the reconstructive surgeon. ⋯ This article focuses on the management of facial fractures in children. Discussed are common fracture patterns based on the development of the facial structure, initial management, diagnostic strategies, new concepts and old controversies regarding radiologic examinations, conservative versus operative intervention, risks of growth impairment, and resorbable fixation.
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Otolaryngol. Clin. North Am. · Oct 2014
ReviewContemporary concepts in management of acute otitis media in children.
Acute otitis media (AOM) is a common disease of childhood. AOM is most appropriately diagnosed by careful otoscopy with an understanding of clinical signs and symptoms. ⋯ Tympanostomy tube placement may be helpful for those who experience frequent episodes of AOM or fail medical therapy. Recent practice guidelines may assist the clinician with such decisions.
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Minimally invasive skull base surgery has advanced substantially with the advent of endoscopic technology, novel instrumentation, and intraoperative image-guidance capabilities. Robotic technology has been accepted into the surgeon's armamentarium, with its implementation into abdominal, thoracic, and head and neck surgery. However, the application of surgical robotics to the skull base has yet to be achieved. This article highlights current preclinical research and applications of robotic surgery to the skull base.
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Otolaryngol. Clin. North Am. · Jun 2014
ReviewTransoral robotic sleep surgery: the obstructive sleep apnea-hypopnea syndrome.
Nocturnal upper airway collapse is often multi-level in nature but typically will involve some degree of obstruction at the level of the tongue-base. Several surgical procedures have been developed in recent years to address this area in patients resistant to continuous positive airway pressure. This article outlines a novel way to treat obstructive sleep apnea lingual obstruction using the da Vinci robotic surgical system. This technique offers significant potential advantages over other established approaches and it should be included in the surgical armamentarium of sleep surgeons.
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We review the therapies for primary headache disorders: migraine, chronic migraine, tension-type headache, and cluster headache. Recommendations follow the evidence-based treatments so far as is possible with expert opinion to give clinical guidance. Headache has 2 levels of care: acute treatments designed to stop a headache from progressing and alleviate all symptoms associated with the headache and preventive therapies for patients whose headache frequency is such that by itself produces significant disability and impact on quality of life, or where the frequency of use of acute medications, regardless of efficacy, poses risks in terms of overuse or adverse events.