Dr. Quinn's Online Textbook of Otolaryngology: Grand Rounds Archive

Página que disponibiliza material educacional preparado por médicos residentes da área de otorrinolaringologia na forma de textos para discussão em grupo. O material pode ser acessado em diversos formatos: pdf, html, doc, docx, ppt e pptx, sendo necessário programas compatíveis para leitura.

Advancing otolaryngology education in the new millennium.

Just as the practice of otolaryngology has changed over the years, so too the educational enterprise that supports the growth and development of the field continues to evolve. Changes in otolaryngology education have been driven by multiple internal and external factors. These changes need to be understood, and a proactive, cooperative approach by the members of this specialty is required to help shape the future in a way that will ultimately benefit both patients and the specialty itself. Rapid growth in the clinical sciences, accelerating technologic developments, and expanding quality improvement initiatives mandate that modern otolaryngologist-head and neck surgeons actively engage in continuing education. As described in many of the articles in this issue of the Otolaryngologic Clinics of North America, the resident in otolaryngology is graduating into a career of lifelong learning.

Optimal design of O-to-Z flaps for closure of facial skin defects.

OBJECTIVE: To determine the optimal design of an O-to-Z flap for closure of facial skin defects. METHODS: Prospective cadaver study. Multiple 2-cm-diameter circular skin defects were created in fresh cadavers. Three types of O-to-Z flaps were designed, varying the angle of a curved line about concentric radii of the defect: acute, intermediate, or wide angle flap. The tension of closure of each was measured and compared at different lengths of incision and extents of undermining. RESULTS: The acute angle flap had a significantly lower closing tension at all lengths of incision and extents of undermining than the intermediate and wide angle flaps. Increasing the amount of undermining alone without incising the flap did not significantly decrease the closing tension. Incising the acute angle flap to 4 radii created a nearly tension-free closure. CONCLUSIONS: The optimal design for reducing tension of the O-to Z flap is an acute angle flap. The optimal length of incision and undermining necessary to minimize closing tension is discussed.

Obstructive supraglottic schwannoma: a case report and review of the literature.

OBJECTIVE: At the conclusion of the current presentation, the participants should be able to describe the etiology, presentation, histopathologic identification, and treatment options for schwannoma of the larynx. OBJECTIVES: Nerve sheath tumors rarely occur within the larynx. The goal of the current report is to acquaint the clinician with the presentation and treatment options for this disease. STUDY DESIGN: Retrospective case report and review of the literature. METHODS: We report one case of schwannoma of the supraglottic larynx at the Department of Otolaryngology, University of Texas Medical Branch (Galveston, TX). In addition, we review English-language publications regarding laryngeal nerve sheath tumors. RESULTS: Laryngeal nerve sheath tumors have an insidious course, commonly involve the supraglottic larynx, and can lead to upper airway obstruction. Cure is achieved by complete surgical excision. CONCLUSIONS: Median thyrotomy has proven to be safe and successful in the treatment of supraglottic schwannoma.