Surgical Management of Inferior Turbinate Hypertrophy in the Era of Widespread Communicable Disease.

Inferior turbinate reduction procedures have been performed for decades. After significant evolution, turbinoplasty and other mucosal-sparing techniques have become the main method to successfully reduce turbinate hypertrophy. The debate of which technique produces the most effective and durable outcomes is ongoing. During this critical era of widespread communicable diseases, including but not limited to COVID-19, HIV, and hepatitis, additional attention is necessary to balance outcomes with a degree of generation of airborne particles when selecting a technique. This review article aims to identify the optimal method for inferior turbinate reduction that weighs both outcomes and aerosol production. The MEDLINE database was searched to discover relevant publications through August 2022. Key search terms included inferior turbinate hypertrophy, turbinate reduction surgery, turbinoplasty methods, surgical management of turbinate hypertrophy, surgical aerosol generation, COVID-19 surgery, surgery smoke plume, SARS-CoV-2 transmission during surgery, and nasal procedures COVID-19 aerosols. Surgical management of the inferior turbinates includes radiofrequency ablation (RFA), microdebrider-assisted turbinoplasty (MAIT), electrocautery, laser, and ultrasound. Piezo-assisted turbinoplasty and a turbinate-specific coblation wand are new additions to the literature. All techniques appear to improve patient symptoms of nasal obstruction. MAIT and RFA are comparable, although MAIT demonstrated better long-term outcomes in some studies and appears to generate fewer airborne particles. Studies evaluating the production of aerosols due to RFA are lacking. Ultrasound outcomes are also excellent and generate no aerosols, but the technique has not been compared against the microdebrider. Electrocautery can result in increased pain and crusting for patients and causes the highest amount of aerosols. Deficiencies of current studies, including a lack of comparison of aerosol generation, duration of follow-up, omission of outfracture, and inadequate randomized controlled trials among existing and new techniques, have limited the identification of the best inferior turbinate reduction method. Given the durability of MAIT and its minimal aerosol production, it can be reinforced as the most sensible technique until further evidence is available.

Virtual otolaryngology interest group meetings and didactic sessions in the COVID-19 pandemic.

The COVID-19 pandemic has placed tremendous strain on medical education and prevented multiple in-person activities like specialty interest group meetings. Specialty interest groups are important resources for students interested in competitive fields like otolaryngology where they may find mentoring, research opportunities, and teaching sessions. To allow continued meetings despite COVID-19, the Texas Tech University Health Sciences Center otolaryngology interest group transitioned to virtual meetings and added student-led didactic sessions. Most students who participated found the virtual didactic sessions helpful and appreciated the opportunity to practice presenting cases. Students were able to network with residents and faculty members, resulting in 60% of participants finding involvement in research projects. Virtual meetings allowed the participation of students from multiple institutions. Participants agreed that the networking, teaching, and research opportunities presented by the virtual sessions made them better applicants for otolaryngology residency. This study provides a framework for transitioning specialty interest group meetings to a virtual platform while adding student-led didactic sessions.

Extranodal natural killer/T-cell lymphoma nasal type.

Extranodal natural killer/T-cell lymphoma nasal type (ENKL) is a rare neoplasm uncommon in the US. Diagnosis is complicated by low incidence and rapid tissue necrosis preventing timely histologic confirmation. We report the case of a 55-year-old woman with ENKL who faced a challenging diagnostic workup due to widespread nasal tissue necrosis and nonspecific sinus-related complaints. While ENKL is significantly more common in Asia and South America, clinicians worldwide should maintain a high level of suspicion for patients presenting with nonspecific nasopharyngeal complaints who have signs of tissue necrosis. Early recognition and treatment with combined radiotherapy and chemotherapy can improve survival.

A Rare Infratemporal Fossa Abscess of the Lateral Pterygoid.

The infratemporal fossa (ITF) contains many critical neurovascular structures and the muscles of mastication. Infections of the ITF are rare and carry significant pathologic implications due to nearby structures. Abscesses of the ITF often occur due to odontogenic spread and present with trismus and facial pain. We present the case of a 26-year-old male with an uncommon ITF abscess of the lateral pterygoid following maxillary wisdom tooth extraction. The abscess resolved following bedside and operative intraoral drainage in addition to intravenous antibiotic therapy. We highlight the rarity of lateral pterygoid abscesses and the importance of distinguishing ITF abscesses from other similarly presenting conditions such as temporomandibular joint dysfunction.

Quality and Readability of Online Patient Education Materials Related to Branchial Cleft Cysts.

Introduction Branchial cleft cysts are the second most common congenital neck mass and can cause significant anxiety for patients and families despite their benign nature. Education through online patient education materials (PEMs) is critical for informing patients and reducing stress. We aimed to determine the content, quality, and readability of online PEMs related to branchial cleft cysts. Methods The search engine Google was used to collect the first 100 website results for the query "branchial cleft cyst." PEMs were included and assessed for content, quality via the DISCERN tool, and readability via Flesch Reading Ease Score (FRES), Flesch-Kincaid Reading Grade Level (FKGL), Gunning Frequency of Gobbledygook (GFOG), and Simple Measure of Gobbledygook (SMOG). Results Twenty-six websites containing PEMs related to branchial cleft cysts were assessed. Most websites were from universities or medical centers and did not contain any media. The mean DISCERN score was 49.3 (SD: 11.1, Median: 52.5), the mean FRES score was 51.9 (SD: 12.1, Median: 54.0), the mean FKGL score was 10.35 (SD: 2.52, Median: 9.95), the mean GFOG score was 13.32 (SD: 2.52, Median: 13.00), and the mean SMOG score was 10.25 (SD: 1.83, Median: 9.95). DISCERN was not significantly correlated with FRES, FKGL, GFOG, or SMOG. Conclusion Online PEMs related to branchial cleft cysts are consistently written above the National Institutes of Health (NIH) recommended sixth-grade reading level and are often of unsatisfactory overall quality. Writers of online PEMs for branchial cleft cysts should consider the readability and quality of their materials to improve patient education and reduce anxiety.

Seizures Related to Neurocysticercosis and Cocaine Use.

Neurocysticercosis (NCC) is an infection of the central nervous system with Taenia solium cysts that most commonly results in seizures. In stable patients without recent symptoms, these seizures may be provoked by seizure threshold-lowering drugs such as cocaine. This case details a 38-year-old male with a past medical history of epilepsy presenting with seizures due to comorbid NCC and cocaine use. This case was complicated by the lack of available information regarding the patient's past medical history and medication use. We highlight the importance of obtaining a full work-up, including brain imaging, to provide optimal treatment for patients with seizures despite a history of drug use.

A Case Report of Olmesartan-Induced Enteropathy.

Chronic olmesartan use can cause a drug-induced enteropathy as a rare side effect leading to diarrhea, significant weight loss, and reduced quality of life. The mechanism of this enteropathy is poorly understood and requires further investigation. We present a case of olmesartan-induced enteropathy resulting in recurrent hospitalizations for intractable diarrhea. Significant enteropathy is more commonly related to infectious or autoimmune causes making the diagnosis of drug-induced enteropathy a challenge. In this case, the lack of significant findings on labs or imaging resulted in a thorough diagnostic work-up revealing olmesartan-induced enteropathy. We present this case to inform providers of the possibility of olmesartan-induced enteropathy and characteristics to identify in other similar cases.