JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Mar 2017
ReviewOptimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society.
Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. ⋯ The evidence base for specific perioperative care elements in head and neck cancer surgery is variable and in many cases information from different surgerical procedures form the basis for these recommendations. Clinical evaluation of these recommendations is a logical next step and further research in this patient population is warranted.
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JAMA Otolaryngol Head Neck Surg · Jan 2017
ReviewZika Virus-What the Otolaryngologist Should Know: A Review.
Initially discovered in 1947, Zika virus infection received little notoriety as a tropical disease until 2015 when an outbreak of microcephaly cases was reported in Brazil. Zika is a single-stranded RNA arbovirus of the Flaviviridae family. The primary source of infection in humans stems from Aedes aegypti mosquito bites but can also occur through sexual, blood, and perinatal transmission. With expectations that 3 to 4 million people across the Americas will be infected over the next year, the World Health Organization has declared this event a Public Health Emergency of International Concern. ⋯ The future outlook regarding the current Zika virus outbreak in the Americas remains uncertain. What is certain is our need to promptly and efficiently address research gaps in our understanding of clinical outcomes from infection and environmental factors that influence emergence meanwhile improving diagnostic, therapeutic, and preventive measures against the disease.
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JAMA Otolaryngol Head Neck Surg · Sep 2016
Review Meta Analysis Comparative StudyElective Neck Dissection vs Observation in Early-Stage Squamous Cell Carcinoma of the Oral Tongue With No Clinically Apparent Lymph Node Metastasis in the Neck: A Systematic Review and Meta-analysis.
The elective management of no clinical or radiologic evidence of lymph node metastasis in the neck (cN0) in early stage T1-T2 oral tongue squamous cell carcinoma (OTSCC) has been the subject of much debate during the past 3 decades and continues to be controversial. ⋯ The findings of this systematic review and meta-analysis indicate that END can significantly reduce the rate of regional nodal recurrence and improve DSS in patients with cT1T2N0 OTSCC.
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JAMA Otolaryngol Head Neck Surg · Sep 2016
ReviewRecognition and Documentation of Strangulation Crimes: A Review.
Strangulation accounts for 10% of violent deaths in the United States and 15% to 20% of deaths associated with domestic violence. However, strangulation deaths represent only a small fraction of nonfatal strangulation assaults, which occur with daily frequency in medium to large US cities. Careful evaluation and documentation of strangulation injuries may identify life-threatening medical conditions, and may facilitate prosecution of strangulation crimes. ⋯ Otolaryngologists should be knowledgeable of the subtle patterns of injury and potentially life-threatening complications of strangulation and should consider domestic violence in women presenting with throat complaints or bruises on the neck.
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JAMA Otolaryngol Head Neck Surg · Aug 2015
Review Meta AnalysisAssociation Between Obstructive Sleep Apnea and Spontaneous Cerebrospinal Fluid Leaks: A Systematic Review and Meta-analysis.
Spontaneous cerebrospinal fluid (CSF) leaks are a morbid condition associated with operative intervention for treatment. Understanding associations are key to diagnosis, treatment, and possible early detection. ⋯ The association between OSA and spontaneous CSF leaks as demonstrated by retrospective studies is confounded by heterogeneous patient characteristics. Large prospective controlled studies using polysomnography and elevated intracranial pressure measurements are required to further evaluate the relationship between OSA and spontaneous CSF leaks.