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Highlights Research Social Impact of Facial Hemangiomas in Preteen Children One might anticipate that as a child matured, any physical stigmata would have impact on growth and development. Costa and colleagues chose to assess the impact of facial hemangiomas both with and without prior treatment in preteen children. They performed an observational study of social anxiety and skills in preteens with facial hemangiomas using 3 accepted psychiatric scales. Thirty of 144 reachable parents of preteens in this category completed questionnaires. The authors found that preteen children with involuted, untreated hemangiomas had higher social anxiety scores in new situations and reduced social initiative scores compared with children who had received therapy. Despite the limited cohort in the study, the question of whether early treatment for facial hemangiomas in obvious facial areas warrants consideration. Rigid Esophagoscopy for Head and Neck Cancer Staging Rigid esophagoscopy became integrated as a part of the standard evaluation of a patient with HNSCC in the 1970s, but times have changed, and less invasive opportunities to evaluate the esophagus now exist. McGarey and colleagues chose to perform a retrospective review of all patients with head and neck cancer who had rigid esophagoscopy performed between 2004 and 2012 for staging purposes to define its true importance in the staging process. The authors found 9 complications in the 601 staging rigid esophagoscopies performed, with 1 esophageal perforation. Of these procedures, 551 were completed; 523 were without pathologic findings; and of the other 28 cases, all findings were nonmalignant. In this study as well as a review of the literature, the incidence of synchronous esophageal primaries in patients with HNSCC is low, and screening with esophagoscopy should be limited to those who are high risk. Reconstruction of the Mandible Without a Tracheotomy Tracheostomy has been the mainstay of airway protection for major head and neck surgery. Lapis and colleagues saw the need to challenge this precept and performed 15 cases of fibula free-flap reconstruction between 2000 and 2014 without a tracheotomy and evaluated their series as well as performed a literature review to learn of commonalities of the patients and the procedure that permitted this to be safely performed. The patient group had a median age of 42 years, were nasally intubated at surgery, and were extubated the following day. Most had the fibula limited to the unilateral mandibular body, and it was purely osseous in most patients. There were no reintubations or complications, with a normal hospital stay. While there may be a selected group of patients who have this procedure performed, this study presents a small “feasibility” study and does not endorse the lack of a tracheotomy in these cases to be the standard. Far more patients and data must be evaluated to fully support this approach in selected cases. Maxillomandibular Advancement for Treatment of OSA There are a plethora of surgical procedures that alleviate obstructive sleep apnea (OSA), but none in all patients. Zaghi and colleagues chose to define which patients would have the best opportunity for the best results from maxillomandibular advancement. They performed a review using aggregated data from multiple studies defined in the Cochrane Library, Scopus, Web of Science, and PubMed. The systematic review was independently performed by 3 coauthors. Data from a total of 518 patients from 45 studies were collated. The authors found that the best results were obtained in the patients with high residual apnea-hypopnea index and respiratory disturbance index after ranking other surgical attempts. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Otolaryngology - Head & Neck Surgery American Medical Association

Highlights

Abstract

Research Social Impact of Facial Hemangiomas in Preteen Children One might anticipate that as a child matured, any physical stigmata would have impact on growth and development. Costa and colleagues chose to assess the impact of facial hemangiomas both with and without prior treatment in preteen children. They performed an observational study of social anxiety and skills in preteens with facial hemangiomas using 3 accepted psychiatric scales. Thirty of 144 reachable parents of preteens in...
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Publisher
American Medical Association
Copyright
Copyright © 2016 American Medical Association. All Rights Reserved.
ISSN
2168-6181
eISSN
2168-619X
DOI
10.1001/jamaoto.2015.1779
Publisher site
See Article on Publisher Site

Abstract

Research Social Impact of Facial Hemangiomas in Preteen Children One might anticipate that as a child matured, any physical stigmata would have impact on growth and development. Costa and colleagues chose to assess the impact of facial hemangiomas both with and without prior treatment in preteen children. They performed an observational study of social anxiety and skills in preteens with facial hemangiomas using 3 accepted psychiatric scales. Thirty of 144 reachable parents of preteens in this category completed questionnaires. The authors found that preteen children with involuted, untreated hemangiomas had higher social anxiety scores in new situations and reduced social initiative scores compared with children who had received therapy. Despite the limited cohort in the study, the question of whether early treatment for facial hemangiomas in obvious facial areas warrants consideration. Rigid Esophagoscopy for Head and Neck Cancer Staging Rigid esophagoscopy became integrated as a part of the standard evaluation of a patient with HNSCC in the 1970s, but times have changed, and less invasive opportunities to evaluate the esophagus now exist. McGarey and colleagues chose to perform a retrospective review of all patients with head and neck cancer who had rigid esophagoscopy performed between 2004 and 2012 for staging purposes to define its true importance in the staging process. The authors found 9 complications in the 601 staging rigid esophagoscopies performed, with 1 esophageal perforation. Of these procedures, 551 were completed; 523 were without pathologic findings; and of the other 28 cases, all findings were nonmalignant. In this study as well as a review of the literature, the incidence of synchronous esophageal primaries in patients with HNSCC is low, and screening with esophagoscopy should be limited to those who are high risk. Reconstruction of the Mandible Without a Tracheotomy Tracheostomy has been the mainstay of airway protection for major head and neck surgery. Lapis and colleagues saw the need to challenge this precept and performed 15 cases of fibula free-flap reconstruction between 2000 and 2014 without a tracheotomy and evaluated their series as well as performed a literature review to learn of commonalities of the patients and the procedure that permitted this to be safely performed. The patient group had a median age of 42 years, were nasally intubated at surgery, and were extubated the following day. Most had the fibula limited to the unilateral mandibular body, and it was purely osseous in most patients. There were no reintubations or complications, with a normal hospital stay. While there may be a selected group of patients who have this procedure performed, this study presents a small “feasibility” study and does not endorse the lack of a tracheotomy in these cases to be the standard. Far more patients and data must be evaluated to fully support this approach in selected cases. Maxillomandibular Advancement for Treatment of OSA There are a plethora of surgical procedures that alleviate obstructive sleep apnea (OSA), but none in all patients. Zaghi and colleagues chose to define which patients would have the best opportunity for the best results from maxillomandibular advancement. They performed a review using aggregated data from multiple studies defined in the Cochrane Library, Scopus, Web of Science, and PubMed. The systematic review was independently performed by 3 coauthors. Data from a total of 518 patients from 45 studies were collated. The authors found that the best results were obtained in the patients with high residual apnea-hypopnea index and respiratory disturbance index after ranking other surgical attempts.

Journal

JAMA Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Jan 1, 2016

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