Current opinion in otolaryngology & head and neck surgery
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Gunshot wounds to the head and neck result in significant bone and soft tissue loss. These defects pose a challenge to the facial reconstructive surgeon. This paper reviews the current literature on the management of ballistic injuries to the head and neck and outlines a treatment algorithm. ⋯ Management of ballistic injuries to the head and neck begins with advanced trauma life support protocols. Computed tomography angiography is now widely available and provides an accurate and rapid evaluation of head and neck vasculature. The initial operation aims to establish occlusion, stabilize bone and close soft tissue defects. Serial debridement of wounds with delayed reconstruction has given way to early definitive repair with vascularized tissue. This has led to improved function, fewer operations, and shorter hospital stays.
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Curr Opin Otolaryngol Head Neck Surg · Jun 2007
ReviewThe role of virtual reality in surgical training in otorhinolaryngology.
This article reviews the rationale, current status and future directions for the development and implementation of virtual reality surgical simulators as training tools. ⋯ Virtual reality simulators are demonstrating validity as training and skills assessment tools. Future prototypes will find application for routine use in teaching, surgical planning and the development of new instruments and computer-assisted devices.
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The treatment of epistaxis has undergone significant changes in recent years. Gone are the days when patients had an uncomfortable posterior nasal pack inserted then spent several days on the ward only to bleed again on its removal. New packing devices, ingenious haemostatic agents and endoscopic surgical approaches have been developed to provide a variety of effective and well-tolerated treatment options. This paper will discuss the evolution and utility of these devices and techniques for managing difficult epistaxis patients. ⋯ Anterior epistaxis is generally easy to control with local cautery. The optimal management of posterior epistaxis is to insert a pack to control the bleeding before taking the patient to the operating theatre to ligate the sphenopalatine artery endoscopically.