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

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Recent Publications

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A Modified Technique of Mouse Vertical Sleeve Gastrectomy Using Two Disposable Micro-clamps

A Modified Technique of Mouse Vertical Sleeve Gastrectomy Using Two Disposable Micro-clamps

VSG is a type of bariatric surgery that is accepted as the simplest but most efficient surgical modality to treat morbid obesity. A mouse model of VSG has been widely utilized to investigate the underlying mechanisms of VSG. There are numerous microsurgical techniques for VSG in mice, and we report herein a modified technique with 2 disposable micro-clamps to simplify the surgery.
Need for Re-classifying the Rare Condition of Ectopic Hamartomatous Thymoma Based on Tumor Analysis

Need for Re-classifying the Rare Condition of Ectopic Hamartomatous Thymoma Based on Tumor Analysis

Ectopic hamartomatous thymoma is a rare neoplasm with classic anatomical location and characteristic histological and immunohistochemical features. Awareness of ectopic hamartomatous thymoma is essential to accurately diagnose these lesions which clinically mimics lipoma. Based on the morphologic and immunophenotypic features, the authors stress the need to discontinue the existing term of ectopic hamartomatous thymoma and replacing it with suitable nomenclature that aptly denotes its phenotype and possible histogenesis. The authors propose a new terminology “Triphasic Epithelial Myoepithelial Mesenchymal Branchial Anlage Tumor (TEMM-BAT)” as it encompasses three important constituents of the lesion (epithelial, myoepithelial, and mesenchymal) and its possible histogenesis in relation to branchial remnants.
Survival Analysis of Upper Arm Replantation After Avulsion Injuries

Survival Analysis of Upper Arm Replantation After Avulsion Injuries

Avulsion injuries and replantation of the upper arm are particularly challenging in the field of traumatic microsurgery. At present, the functional recovery of the avulsion injuries upper arm after the replantation is generally not ideal enough, and there is no guideline for the surgeries. The aim of this study was to analyze the causes of failure of the upper arm replantation for avulsion injuries, summarize the upper arm replantation’s indications, and improve the replantation methods.
The Utility of Barium Swallow Studies for Evaluation of Pharyngocutaneous Fistula After Total Laryngectomy

The Utility of Barium Swallow Studies for Evaluation of Pharyngocutaneous Fistula After Total Laryngectomy

The authors review the accuracy of barium swallow studies in the assessment of post-laryngectomy pharyngocutaneous fistula. The findings are significant in that they will help guide practitioners in swallow assessment decision making and perhaps lead to a standardized protocol.
Portable Electronic Device: An Alternative Tool for Surgical Magnification

Portable Electronic Device: An Alternative Tool for Surgical Magnification

The article describes the authors' experience in the use of a smartphone as an accessible, versatile, and affordable alternative magnification device for microsurgery training. The authors conducted the first statistical comparison between portable electronic magnification devices and conventional magnification devices focused on microsurgery training.
Blockchain Technology and Healthcare Applications

Blockchain Technology and Healthcare Applications

This article describes how blockchain technology can be used in key data-driven healthcare areas, including health care records, health claims, interoperability, patient access, and supply chains.
Effective Management of Epistaxis

Effective Management of Epistaxis

There have been several developments in the management of epistaxis. In this article, the author has reviewed the literature on epistaxis, its anatomy, etiology, and the current developments in its treatment. The stepwise treatment algorithms and flow diagram provided in the article will guide the clinicians to produce better results in epistaxis management.

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!

Vascularized Lymph Vessel Transfer for Extremity Lymphedema - Is Transfer of Lymph Node Still Necessary?

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.

Editor's Choice

Articles
News
Videos
Dangers of a False Sense of Security in a Huge Mastoid Cholesteatoma With Skull Base Erosion and Cerebrospinal Fluid Leakage

Dangers of a False Sense of Security in a Huge Mastoid Cholesteatoma With Skull Base Erosion and Cerebrospinal Fluid Leakage

The author reports a case involving a 59-year-old man with delayed presentation of a huge mastoid cholesteatoma complicated by skull base erosion and cerebrospinal fluid leakage. Delayed presentation of this disease entity can have negative health consequences for patients. Regular otologic examinations, audiologic follow-up, and imaging examinations are viewed as the most effective strategies for the prevention of this type of situation. Early recognition of cholesteatomas is essential, as appropriate and timely treatment can prevent this rare comorbid condition from becoming fatal.
Voice, Cough, and Diurnal Breathing Problems and Quality of Life in Obstructive Sleep Apnea

Voice, Cough, and Diurnal Breathing Problems and Quality of Life in Obstructive Sleep Apnea

The study identifies how current voice, cough, and daytime breathing problems affect mental and physical quality of life in obstructive sleep apnea patients, as well as how the combination of voice, cough, and diurnal dyspnea impacts quality of life.
Neuroplastic Effect of Constraint-Induced Music Therapy on Hearing Recovery in Patients with Sudden Sensorineural Hearing Loss

Neuroplastic Effect of Constraint-Induced Music Therapy on Hearing Recovery in Patients with Sudden Sensorineural Hearing Loss

Constraint-induced music therapy has been shown to enhance hearing recovery in patients with sudden sensorineural hearing loss by preventing maladaptive reorganization of the auditory cortex. This study was the second research to provide scientific evidence related to the neuroplasticity of the central auditory nervous system in response to constraint-induced acoustic rehabilitation.
Current State of Surgical Simulation Training in Otolaryngology: Systematic Review of  Simulation Training Models

Current State of Surgical Simulation Training in Otolaryngology: Systematic Review of Simulation Training Models

The review article presents an expansive list of otolaryngology-specific surgical simulation training models as described in Otolaryngology literature as well as evaluates recent advances in simulation training in Otolaryngology.
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.
Head and Neck Juxtacortical Chondrosarcoma

Head and Neck Juxtacortical Chondrosarcoma

The incidence of Head and Neck Juxtacortical Chondrosarcoma (HNJCS) is extremely rare. Among a large database, the authors could identify only nine cases of HNJCS that have been amply described. It has been observed that irrespective of the location of the body, HNJCS has a consistent clinical and diagnostic profile. HNJCS is generally a low or intermediate grade malignancy with a low rate of recurrence and metastases. Primary surgical excision with negative margins was found to be the therapeutic modality of choice.  Radiotherapy and chemotherapy have limited roles in the management of HNJCS.

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!

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.