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Honorary Editor-in-Chief of AOHNS: Dr. Murray Grossan

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Updates on the Management of Epistaxis

Updates on the Management of Epistaxis

Epistaxis (i.e., nosebleed) is a common otolaryngologic emergency; however, it is seldom life-threatening and most minor nosebleeds stop on their own or under primary care from medical staff. Nonetheless, cases of recurrent epistaxis should be checked by an otolaryngologist, and severe nosebleeds should be referred to the emergency department to avoid adverse consequences, including hypovolemic shock or death. This paper reviews current advances in our understanding of epistaxis as well as updated treatment algorithms to assist clinicians in optimizing outcomes.
How Stephen Hawking Defied Amyotrophic Lateral Sclerosis for Five Decades

How Stephen Hawking Defied Amyotrophic Lateral Sclerosis for Five Decades

Stephen Hawking died in Cambridge on March 14, 2018 at the age of 76. He has been described as one of the greatest scientific minds in history and the most popular scientific figure since Albert Einstein. He is also a symbol of human courage and persistence, having continued in his work for decades in spite of a debilitating disease that left him confined to a wheelchair. Hawking was diagnosed with amyotrophic lateral sclerosis (ALS) in his early twenties. This rare disease leads to gradual decline of the brain’s ability to control muscles. Doctors predicted that he would live for only a few years, but the advance of the disease was slower than expected, thereby allowing him to pursue an illustrious career articulating theories of the cosmos and bringing science to the forefront of popular culture.
Drug-Related Polyarthralgias with Levodopa-Carbidopa

Drug-Related Polyarthralgias with Levodopa-Carbidopa

This case report characterizes the clinical course of a 79-year-old man with idiopathic Parkinson disease who developed polyarthralgia following commencement of levodopa-carbidopa therapy, resolution of the polyarthralgia with discontinuation of it, and subsequent reappearance of polyarthralgia when the medication was restarted. The time-locked relationship between polyarthralgia and levodopa-carbidopa treatment suggests that this is an adverse drug reaction. The possible pathophysiologic basis of this unusual reaction is discussed.
The Role of Three-Dimensional Ultrasound in Gynecology

The Role of Three-Dimensional Ultrasound in Gynecology

3D volume imaging is the most important advantage in modern sonography after the introduction of the vaginal probe. The great use of 3D ultrasound in obtaining valuable medical details is undoubted and it could replace MRI scans in gynecology patients as it is able to provide the same or even better views. The review article addresses how to obtain optimum 3D images and some of the possible clinical applications of this technique. The review also addresses in more detail the three major steps in obtaining 3D images, which are volume acquisition, volume display, and volume analysis.
Pedicled Anterolateral Thigh Flap for Abdominal Reconstruction Following Surgical Resection of Gynecological Abdominal Wall Malignancy

Pedicled Anterolateral Thigh Flap for Abdominal Reconstruction Following Surgical Resection of Gynecological Abdominal Wall Malignancy

Patients with gynecological abdominal wall malignancies can benefit significantly from radical resection and autologous reconstruction. The pedicled anterolateral thigh flap is the preferred donor site, offering a reliable solution to abdominal wall reconstruction in this setting. The satisfactory results should prompt a more aggressive surgical approach for these patients. This article describes the authors experiences with the abdominal reconstruction following surgical resection of gynecological abdominal wall malignancy using pedicled anterolateral thigh flap.
Aberrant Renal Vessels

Aberrant Renal Vessels

A 55-year-old postmenopausal lady was presented with recurrent carcinoma of ovary. A computed tomography scan of the abdomen was performed after neoadjuvant chemotherapy, showing retroaortic left renal vein and precaval right renal artery, along with the resolution of previous vaginal vault lesion. The intraoperative findings revealed a peritoneal carcinomatosis index of 3, according to an incidental deposit found on the vaginal vault infiltrating into the rectum. During retroperitoneal lymph node dissection, as part of the procedures in cytoreduction, aberrant renal vessels were identified. A complete clearance was done safeguarding the vessels as seen in the intraoperative image.
Muscle Relaxant Administration to Manage Severe Tracheomalacia

Muscle Relaxant Administration to Manage Severe Tracheomalacia

Tracheomalacia is a rare congenital abnormality of the tracheobronchial cartilage causing the collapse of the airway and obstruction of expiratory flow. It is very difficult to manage infants with severe tracheomalacia. Severe cases lead to worse respiratory conditions and may become life-threatening, and necessitate immediate surgical treatment. Takeshi Yano of the University of Miyazaki, Japan has published an article in the Annals of Case Reports and Images Journal, in which a method to manage severe tracheomalacia patients using muscle relaxant has been discussed.

Relationship between Depression and Cholesteatoma

Relationship between Depression and Cholesteatoma

The study by Dr. Chin-Lung Kuo provided strong evidence, which was unrecognized earlier, to establish the potential link between cholesteatoma and depression. It is necessary to conduct routine psychiatric screening and monitoring of cholesteatoma patients for detection and treatment at the beginning stage itself. Despite the accuracy and acceptability of this population-based study, more prospective studies need to be carried out for additional confirmation.

Safety Science Principles for Administration of Oxytocin and Magnesium Sulfate in Labor & Delivery Units

Safety Science Principles for Administration of Oxytocin and Magnesium Sulfate in Labor & Delivery Units

The Institute of Safe Medication Practices has listed Oxytocin and Magnesium sulfate as high-alert medications causing significant harm to patients when used in error. Since these medications are frequently used in Labor & Delivery (L&D) units, safe administration to prevent medication errors is necessary for these units. As a part of the Safety Program for Perinatal Care (SPPC) of the Agency for Healthcare Research and Quality (AHRQ), several L&D units opted for implementing safety science principles for the safe administration of oxytocin and magnesium sulfate. The research team led by Kayla B Gray has published a qualitative research article in the Research on Women’s Health Journal, which describes the experiences of 25 L&D units, which have opted to implement the safety science principles for the safe administration of these medications.

Otolaryngology Simulation to Manage Oropharyngeal Hemorrhage

Otolaryngology Simulation to Manage Oropharyngeal Hemorrhage

Oropharyngeal hemorrhage is a serious complication of oropharyngeal tumor that occurs instantly without any warning and may result in airway obstruction and respiratory distress. The bleeding, if not controlled effectively, can be life-threatening. The management of such cases without prior experience can make the situation too complex. Considering the critical nature of such bleeding, a simulation scenario was created where the junior Otolaryngology residents (interns) could learn to manage the patients with oropharyngeal hemorrhage safely and properly interact with the fellow healthcare providers. This simulation scenario was designed and developed by a team of senior medical professionals from New York, led by Joshua Feintuch. A detailed article of the simulation program is published in the Archives of Otorhinolaryngology-Head & Neck Surgery Journal.

Welcome Dr. Chin-Lung Kuo as Deputy Editor in Archives of Otorhinolaryngology-Head & Neck Surgery

Welcome Dr. Chin-Lung Kuo as Deputy Editor in Archives of Otorhinolaryngology-Head & Neck Surgery

It is our pleasure to invite Dr. Chin-Lung Kuo to be Deputy Editor in Archives of Otorhinolaryngology-Head & Neck Surgery!

A Full Waiver of the First Submission from June 20, 2018 to July 31, 2018!

A Full Waiver of the First Submission from June 20, 2018 to July 31, 2018!

If you would like to continue hearing from us and receiving a full waiver of the first submission from June 20, 2018 to July 31, 2018, please complete your registration.

Laryngoscopic examination for signs of laryngeal irritation associated with reflux

This video shows a laryngoscopic examination for signs of laryngeal irritation associated with laryngopharyngeal reflux. Large bilateral granulomas are identified on the surface of bilateral arytenoids

Role of Trapezius Transfer for Shoulder Reconstruction in Adult Traumatic Brachial Plexus Injuries: Literature Review

This is a video abstract regarding the article on the role of trapezius transfer for shoulder reconstruction in adult traumatic brachial plexus injuries.

Immediate Limb Compression Following Supermicrosurgical Lymphaticovenular Anastomosis – Is It Helpful or Harmful?

In this video, the authors describe how they set out to assess the effect of external limb compression on the lymphaticovenular anastomosis.

An Unusual Nasal Mass: The Sinonasal Teratocarcinosarcoma

In this video, the author discusses an unusual nasal mass (i.e., teratocarcinosarcoma) in the the sinonasal cavity.

Strategic Incision Placement to Facilitate Successful Supermicrosurgical LVA

In this video, the author describes their guided approach to incision placement to increase the likelihood of creating a successful lymphaticovenular anastomosis at each incision for an effective treatment for lymphedema.

Surgical Technique and Risk of Post-tonsillectomy Hemorrhage

A study conducted by Motta et al. showed that no significant difference in the primary, secondary and total hemorrhage frequency between surgical techniques for tonsillectomy.

Editor's Choice

Articles
News
Videos
The ‘Orochi’ Flap Concept: Multi-Stage Combined Flap Using Sequential Flaps

The ‘Orochi’ Flap Concept: Multi-Stage Combined Flap Using Sequential Flaps

Prof. Koushima, president of World Society for Reconstructive Microsurgery, proposes an innovative concept and technique of the multi-stage ‘Orochi’ combined flaps (sequential flaps in parallel). The technique opens a new vista in reconstructive microsurgery.
Head and Neck Juxtacortical Chondrosarcoma: A Systematic Review

Head and Neck Juxtacortical Chondrosarcoma: A Systematic Review

This is a case report with a comprehensively systematic review on juxtacortical chondrosarcoma in the head and neck area (HNJCS). According to the study, only nine cases of HNJCS have been adequately described. HNJCS have relatively consistent clinical and diagnostic profile regardless of location in the body. Surgical management yields excellent outcomes with low recurrence rates.
Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

A higher titer of IA-2Ab reflects a reduced pancreatic size in the patients with Type 1 diabetes (T1D), especially in those with the acute-onset form of the disease. The potential mechanisms underlying the reduced pancreatic size might differ between acute-onset T1D and slowly progressive insulin-dependent diabetes mellitus. The authors investigated the relationship between islet autoimmunity and pancreatic size in the Japanese patients with T1D.
An Unusual Foreign Body Within the Pterygopalatine Fossa: A Case Report

An Unusual Foreign Body Within the Pterygopalatine Fossa: A Case Report

Air gun injuries normally present with a wide variety of clinical forms from minor to life-threatening injuries. The rare case of an air gun pellet retained in the pterygopalatine fossa has the risk of immediate or delayed haemorrhage as illustrated by our patient. Gunshot injuries must be considered as potentially life-threatening and raising awareness regarding its potential threats are required in order to minimize the air gun injuries, especially in children.
Laryngopharyngeal Reflux: An Update

Laryngopharyngeal Reflux: An Update

Otolaryngologists and gastroenterologists seem to differ in their definitions and management of laryngopharyngeal reflux (LPR). In this review article, the author suggests a multidisciplinary approach to LPR diagnosis. Based on the latest findings, the author proposes an algorithm to facilitate the assessment and management of LPR.
Lymphaticovenular Anastomosis for Persistent Immunosuppressant-Related Eyelid Edema

Lymphaticovenular Anastomosis for Persistent Immunosuppressant-Related Eyelid Edema

This case report demonstrates an important supermicrosurgical technique for lymphedema, which was established by Isao Koshima in 1994. So far, over 2,000 cases of limb edema have been treated by this surgical method.
Assessment and Management of Laryngopharyngeal Reflux

Assessment and Management of Laryngopharyngeal Reflux

In this article, the author reviews the manifestations, diagnosis, and treatments of LPR and suggests adopting a multidisciplinary approach for a reliable and conclusive diagnosis of LPR. Based on the previous research and latest findings, an algorithm is put forth to streamline the assessment and management of reflux disorders. Highlighting the significance of correct diagnosis and effective treatment of LPR, the author suggests that in case the diagnosis is doubtful, and the therapeutic response is unsatisfactory, the patient should be referred to a specialist.

A Comparison of Hematology and Cytology Laboratories in Detection of Body Fluid Malignancy

A Comparison of Hematology and Cytology Laboratories in Detection of Body Fluid Malignancy

Based on the comparison between the hematology and cytology, the authors concluded that by improving the skills of the technologists of the hematology laboratory in identifying cell morphology, the diagnostic values in body fluid malignancy could be improved, and the hematology laboratory would achieve comparable competency similar to the cytology laboratory.

Can the Cervical Length Predict Procedure-Related Miscarriage?

Can the Cervical Length Predict Procedure-Related Miscarriage?

Procedure-related miscarriage is the most crucial complication of the prenatal invasive tests which are being used for the diagnosis of fetal aneuploidies. Even though several risk factors like operator experience, gestational age, sampling route, and the number of tapping have been suggested for the procedure-related miscarriage, the cause of this complication remains unknown. The results of the study confirmed that the cervical lengths in the patients complicated with miscarriages were within normal limits.

The Brain Functions Mathematically!

The Brain Functions Mathematically!

The brain can process information, store them, and retrieve them as and when required; however, we hardly know much about the physiological mechanisms behind such fundamental functions of the brain. The efforts by psychologists, scientists, engineers, physicists, and mathematicians over the past decades have given some significant insight on the brain functions and have been helpful for carrying out further research on the subject.

Welcome Prof. Isao Koushima as Honorary Editor-in-Chief in International Microsurgery Journal

Welcome Prof. Isao Koushima as Honorary Editor-in-Chief in International Microsurgery Journal

It is our pleasure to invite Prof. Isao Koushima to be Editor-in-Chief in International Microsurgery Journal!

Welcome Prof. Zeng-Tao Wang (王增涛) as Honorary Editor-in-Chief in International Microsurgery Journal

Welcome Prof. Zeng-Tao Wang (王增涛) as Honorary Editor-in-Chief in International Microsurgery Journal

It is our pleasure to invite Prof. Zeng-Tao Wang (王增涛) to be Editor-in-Chief in International Microsurgery Journal!

Experience with Robotic-assisted Microsurgery

Over the past decade, Da Vinci Surgical System has made great strides in surgery. It has been widely applied in urology, gynecology, bariatric surgery, hepatobiliary surgery, thoracoscopic surgery, cardiac surgery, neurological surgery, and transoral otolaryngologic neoplasm resection. However, its application in plastic and reconstructive surgery still in the preliminary stages of development. I went to Hong Kong in April 2013 for the robotic surgical system training program and was awarded console surgeon certificate.

Chang's Technique of Sequential End-to-Side Microvascular Anastomosis

This novel technique of sequential ETS micro-venous anastomosis is a modified technique from its classical form. The unique use of vessel loops provides protection to the vessel, while it achieves equisegmental IJV occlusion for sequential (proximal to distal) venous anastomosis. This method not only saves precious operating time from repetitive positioning of instruments and recipient vessel (IJV), but also creates a safer operating field for the microsurgeons. Utilizing a second single vascular clamp over the anastomosis junction provides an anchoring point for self-retraction by revealing and maintaining an accessible position to the posterior wall, once it is turned at 180 degrees laterally. This maneuver allows the surgeon to have full control of the surgical field and perform ETS micro-venous anastomosis confidently and independently.

Lateral Plantar Artery as Recipient Vessel for Microsurgical Lateral Plantar Forefoot Reconstruction

Division of the lateral plantar artery does not jeopardize the foot circulation because of anastomosis of the lateral plantar artery with the dorsalis pedis artery at the first intermetatarsal space. However, care should be taken with patients with peripheral artery occlusive disease and the flow of dorsalis pedis artery should be confirmed before surgery. Given the advantages of sizable vessel, easy dissection, and proximity to the defect, we believe that the lateral plantar artery might be a valuable option as recipient vessel for lateral plantar forefoot reconstruction.

The Versatility of Pedicled Anterolateral Thigh Flap - A Tertiary Re-ferral Center Experience from India

Pedicled anterolateral thigh flap is a versatile option for reconstruction of complex soft tissue defects in varied anatomical regions. Its wide arc of rotation and less donor site morbidity are its added advantages.

A Great Opportunity to Meet and Learn from Peripheral Nerve Experts

The 2nd instructional course for adult brachial plexus injuries is a fantastic opportunity to meet and learn from experts in the field. We cordially invite you to visit Chang Gung Memorial Hospital to participate in this unique learning experience.

Interview with Dr. Murray Grossan, the Honorary Editor-in-Chief of AOHNS

An exciting conversation with Dr. Murray Grossan, the Honorary Editor-in-Chief of Archives of Otorhinolaryngology-Head & Neck Surgery (AOHNS). Dr. Murray Grossan talked about AOHNS’s new direction and the important means for communicating scientific work to complement teaching and training in the field of medicine.