ABSTRACT
Throughout history, many innovations have contributed to the development of modern otolaryngological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern otolaryngological surgery: Operative Microscope, Hopkins Rigid Endoscope, Laryngeal Nerve monitoring, Cochlear implants and Laser surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of otolaryngological surgery and their ongoing relevance in contemporary and perioperative practice.
ABSTRACT
INTRODUCTION: Vascular lasers may represent a promising treatment option for periorbital veins. This article aims to: (1) systematically review the literature on the safety and effectiveness of vascular laser treatment for periorbital veins and (2) assess safety and effectiveness through a retrospective case series. METHODS: Systematic review: Articles that assessed the safety and effectiveness of vascular laser treatment for periorbital veins were included and quality assessed using the Downs and Black checklist. CASE SERIES: Patient records were retrospectively reviewed from January 2020 to November 2023 to identify all patients who underwent laser treatment for periorbital veins. Outcomes assessment included percentage improvement, patient overall satisfaction and adverse effects. RESULTS: Systematic review: Three articles were included, discussing treatment of blue, periorbital veins using a 1064 nm Nd:YAG laser. Patient Fitzpatrick skin Types I-IV were treated with high patient satisfaction rates and complete clearance of treated veins. Adverse effects included pain, erythema, mild oedema, urticaria and blister formation. Quality of included studies ranged from 7 to 14 out of 21 points. CASE SERIES: Thirty-four patients with skin Types I-V were included. Blue and red periorbital veins were treated using 1064 and 532 nm wavelengths respectively. Mean percentage improvement was 4.8 (complete resolution) and patients' overall satisfaction was ranked 3 (completely satisfied). Adverse effects included erythema, oedema, and bruising. CONCLUSION: Treatment of red and blue periorbital veins using 532 and 1064 nm vascular lasers appears a safe treatment option. The procedure has a short recovery time, with patients able to resume normal activities within 1 day of treatment.
ABSTRACT
We would like to comment on the article entitled "Association between cytokine profiles and lung injury in COVID-19 pneumonia" by Li-Da Chen and colleagues, with respect to emerging data regarding the immunopathogenesis of COVID-19. Chen et al. demonstrated the relevance of IL-2R, IL-6 and TNF-α in the cytokine storm and IL-6 as an independent predictor for COVID-19 severity. Del Valle et al. corroborated these findings with regard to IL-6 and disease severity, however, they also showed IL-8 to be of significance. This may be explained by the varying techniques used by the two studies to determine severity. Further studies including critically ill patients and the analysis of mortality rates in this patient cohort would greatly enhance the clinical relevance of these findings. As speculated by Chen et al., early studies on the use of tocilizumab in COVID-19 patients were promising, however, full results from ongoing trials are required to confirm a survival benefit in patients treated with tocilizumab. Moreover, investigating the roles of other pro-inflammatory cytokines and their impact on disease severity could potentially inform novel therapeutic targets.
