Current opinion in otolaryngology & head and neck surgery
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Curr Opin Otolaryngol Head Neck Surg · Jun 2005
ReviewThe contemporary approach to diagnosis and management of peritonsillar abscess.
Peritonsillar abscess is a common problem, but some aspects of diagnosis and management remain controversial. We review the recent literature on peritonsillar abscess. ⋯ The use of steroids may be beneficial in the treatment of peritonsillar abscess, and different techniques for abscess drainage are still used around the world, with consistently good results.
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Curr Opin Otolaryngol Head Neck Surg · Oct 2004
Review Comparative StudyMechanisms of tinnitus generation.
The current understanding of mechanisms of tinnitus generation is continuing to advance. This review is intended to outline new knowledge in the areas of neuroanatomy, physiology, psychophysics, and brain imaging that are revealing novel mechanisms of tinnitus development. Advances in these areas will open new avenues for effective treatment of tinnitus. ⋯ Our understanding of the mechanisms that lead to a phantom auditory perception, and the associated debilitating consequences of this sensory experience, is continuing to improve. Tinnitus appears to be significantly affected in complex ways by somatosensory, limbic, and motor influences. Effective treatments will certainly emerge from these new areas of research.
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Curr Opin Otolaryngol Head Neck Surg · Jun 2004
ReviewBotulinum toxin and the management of chronic headaches.
There is an increasing number of reports on botulinum toxin in pain therapy, in particular in headache treatment. Therefore, the studies available from reference systems and published congress contributions on the prophylactic treatment of idiopathic and cervicogenic headache with botulinum toxin were analyzed with respect to study design, headache diagnosis, and the significance of results. ⋯ Most open studies and case reports suggest an efficacy of botulinum toxin in headache prophylaxis but double-blind, placebo-controlled studies do not confirm this assumption. Larger controlled studies are needed for a definite evaluation of subgroups that might possibly benefit from such a treatment. Migraine, tension-type headache, and cervicogenic headache cannot be regarded as a general indication for a treatment with botulinum toxin.
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Curr Opin Otolaryngol Head Neck Surg · Jun 2004
ReviewContemporary trends in acute pain management.
In the management of acute pain, the ability to prevent the onset of pain in the immediate postoperative period, lessen its intensity, and interfere with the development of sensitization contributing to hyperalgesia for days following a procedure can greatly benefit the patient, rather than postoperative attempts to decrease pain after it has reached full intensity. ⋯ Careful selection of an effective analgesic regimen can prevent the stress and anxiety associated with acute postoperative pain and breakthrough pain. Pain prevention has greater benefits than attempts at rescue therapy when pain exacerbation occurs. A variety of pain management regimens are presented based on empirical estimates of pain intensity and an application of sound pharmacological principles.
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Curr Opin Otolaryngol Head Neck Surg · Dec 2003
ReviewCurrent airway management in craniofacial anomalies.
Airway obstruction requiring intervention occurs frequently among children with craniofacial anomalies. The presence of a craniofacial anomaly is a common reason for tracheotomy in the pediatric population. Because of the complications associated with tracheotomy, however, numerous other methods have been proposed to alleviate severe airway obstruction in this patient population. ⋯ Multiple options exist for relieving upper airway obstruction in craniofacial patients, and the application of these treatment strategies is dependent on the patient's disease and the philosophy of the treating institution. Future research into the management of airway obstruction in children with craniofacial anomalies will need to focus on predicting which children will benefit from conservative management and which children will need distraction osteogenesis or a tracheotomy.