July 13, 2011 Yavuz Beyazit, MD, Murat Kekilli, MD, Tugrul Purnak, MD, and Jeffrey Spiegel, MD, Professor
March 1, 2011 Christopher Y. Chang, MD and H. Stewart Lindsey, RO
February 1, 2011 K.J. Lee, MD and Robyn M. Smith, MS, MEd, CCC-A, PA-C
September 30, 2010 Raymond C. Maguire, DO, John Gull, DO, Michael Weaver, MD, and Robert T. Sataloff, MD, DMA, FACS
article
Abstract
Cerebrospinal fluid (CSF) fistulae have been encountered by otolaryngologists often since the advent of modern endoscopic sinus surgery, otologic surgery, and skull base surgery. Treatment of CSF leaks may include bed rest, head-of-bed elevation, stool softeners, external spinal fluid drainage, and surgery. External CSF drainage is accomplished via a lumbar spinal drain. Placement of spinal drains is often performed by neurosurgeons and anesthetists. A few otolaryngologists have been trained in the placement and management of lumbar drains, but at most otolaryngology training institutions, education in lumbar drains is not provided. However, in some circumstances, it may fall to an otolaryngologist to accomplish the task. We believe that every otolaryngologist, from the generalist in private practice to the academic neuro-otologic surgeon, should understand the proper technique for the insertion and management of a lumbar drain. Otolaryngologists should be familiar with the physiologic properties of CSF, the methods used to diagnose fistulae, and the techniques used to repair leaks. External spinal drainage is an important element in the management of CSF fistulae, and it has been used in treating perilymphatic fistulae and “gushers.” Much controversy surrounds its routine use. Otolaryngologists need to understand the risks, benefits, and outcomes of spinal drain use in order to decide which patients may benefit from this procedure.
September 30, 2010 Itzhak Brook, MD, MSc
May 31, 2010 Peak Woo, MD
article
It seems to me that the longer one practices, the more difficult it becomes not to become cynical about claims of new and great technology. This is especially true when it comes to investing in expensive new technology.
January 1, 2010 Leslie K. Winter, MD and Jeffrey H. Spiegel, MD, FACS
article
Abstract
In an effort to achieve weight loss, many people are pursuing alternative medical interventions. Widely available as a variant of acupuncture, ear stapling (in which a surgical staple is placed in the conchal bowl of the ear) is reported by practitioners to decrease the appetite and induce weight loss. This practice lacks proven efficacy and has a significant risk of infection and deformity. We report a series of 3 patients who developed complications from ear stapling and present this article to describe the practice so that physicians will be prepared when encountering a staple in the ear.
December 1, 2009 Rick L. Nissen, MD
article
As America's population ages with the baby boomer generation reaching retirement age, the incidence of hearing impairment within the general population is projected to rise significantly. Although hearing loss is not limited to the elderly, its associated problems are certainly most prevalent among senior citizens.
October 31, 2009 Aaron G. Benson, MD and Hamid R. Djalilian, MD
article
Abstract
Hydroxyapatite bone cement is a versatile material used to reconstruct many types of bony surgical defects, and its applications have been widely reported in the literature. Still, complications of its use do occur. We describe 2 cases of hydroxyapatite resorption and subsequent seroma formation in patients who had undergone retrosigmoid craniotomy. The presentation in both cases mimicked a CSF leak. In both cases, the fragmented cement was removed, and the patient experienced no further complications. While hydroxyapatite cement is a highly useful product for the reconstruction of some craniofacial or skull base defects, we believe that it should not be used for the reconstruction of retrosigmoid/suboccipital craniotomies because it is associated with unacceptably high complication rates. Surgeons must exercise caution in selecting candidates for hydroxyapatite reconstruction of cranial defects.
September 30, 2009 P.A.C. van Vuuren, MD, Sarah H. Kagan, PhD, RN, and Ara A. Chalian, MD, FACS
article
Abstract
Interest in addressing the health needs of older adults and improving their outcomes is burgeoning in otolaryngology, but the availability of practical strategies to achieve these aims is limited. In this article, we describe how otolaryngologists can capitalize on collaboration with nurses to create a toolbox of quick and effective strategies that can be incorporated into outpatient otolaryngology practice. The toolbox was compiled by a collaborative team of three: an otolaryngologist-head and neck surgeon who specializes in microvascular reconstruction, a geriatrician completing a second residency in otolaryngology, and a gerontologic clinical nurse. We selected and developed these strategies to fit within the framework of standard otolaryngology practice based on evidence we gathered from the geriatric literature and our own collective academic and clinical experience. We review our criteria for selecting each of the 10 items in our toolbox, and we discuss the potential benefits of each.
September 30, 2009 Ara A. Chalian, MD, FACS
article
Abstract
Geriatric otolaryngology is an emerging medical subspecialty developed in response to a pressing societal need. In this article, the author explains the rationale for this new subspecialty, reviews the landmark events that led to the creation of an organizational structure, celebrates the accomplishments that have been achieved thus far, and discusses the challenges that remain and the opportunities for future growth.
August 31, 2009 Robert T. Sataloff, MD, DMA, FACS, Editor-in-Chief
article
Otolaryngology-head and neck surgery offers one of the most sought-after residencies in American medicine. Most otolaryngology residencies are excellent, and essentially all provide comprehensive training that prepares graduates to provide superb clinical care.
