Designed to enhance the learning experience for both practicing otolaryngologists and otolaryngology residents, Bailey’s Head & Neck Surgery—Otolaryngology, 6th Edition, delivers concise, practical information in all areas of this complex field. Dr. Clark A. Rosen (Laryngology) and his hand-picked editorial team representing all of the sub-disciplines of Head & Neck Surgery-Otolaryngology of Drs. Stacey Gray (rhinology), Patrick Ha (Head and Neck Surgery), Charles Limb (Otology), Stephen Park (Facial Plastics and Reconstructive Surgery), and Gresham Richter (Pediatric Otolaryngology) ensure that all content in this two-volume text is current, useful, and evidence based. Each chapter has been written to increase the reader’s understanding, retention, and ability to successfully apply information in everyday practice.
1. INTRODUCTION - p. 3 2. THE CRANIUM - p. 3 3. CRANIAL FOSSAE - p. 4 4. EYELID, ORBIT, AND EYE - p. 5 5. THE EAR - p. 8 6. NOSE AND PARANASAL SINUSES - p. 10 7. THE FACE - p. 13 8. ORAL STRUCTURES - p. 14 9. PHARYNX AND LARYNX - p. 18 10. THE NECK - p. 20 11. 2 Perioperative Management - p. 25 12. INTRODUCTION - p. 25 13. PREOPERATIVE EVALUATION - p. 25 14. PREOPERATIVE MALNUTRITION - p. 25 15. HEMATOLOGIC ABNORMALITIES - p. 25 16. THROMBOEMBOLIC DISEASES - p. 27 17. ENDOCRINE ABNORMALITIES - p. 28 18. CARDIOVASCULAR DISORDERS - p. 29 19. PULMONARY DISORDERS - p. 30 20. GASTROINTESTINAL DISORDERS - p. 31 21. RENAL DISEASE - p. 32 22. NEUROPSYCHIATRIC PROBLEMS - p. 32 23. GENERAL CONSIDERATIONS - p. 33 24. GERIATRIC PATIENTS - p. 34 25. SURGERY IN THE CHEMICALLY OR ALCOHOL-DEPENDENT PATIENT - p. 35 26. ENHANCED RECOVERY AFTER SURGERY - p. 35 27. 3 Critical Care - p. 39 28. MECHANICAL VENTILATION - p. 39 29. TISSUE OXYGENATION AND ORGAN PERFUSION - p. 44 30. BLOOD TRANSFUSIONS IN THE ICU - p. 45 31. SHOCK - p. 47 32. VASOACTIVE AGENTS IN THE ICU - p. 48 33. PULMONARY EMBOLISM - p. 50 34. INFECTIONS - p. 50 35. ACUTE KIDNEY INJURY - p. 52 36. THE USE OF PERIOPERATIVE BETA BLOCKER PROPHYLAXIS IN THE ICU - p. 54 37. ATRIAL FIBRILLATION - p. 54 38. PAIN MANAGEMENT AND SEDATION IN THE ICU - p. 55 39. GASTRIC ACID SUPPRESSION - p. 57 40. PALLIATIVE CARE AND ICU - p. 58 41. 4 The Dynamics of Wound Healing - p. 61 42. INTRODUCTION - p. 61 43. THE NORMAL WOUND HEALING PROCESS - p. 61 44. FACTORS AFFECTING WOUND HEALING - p. 66 45. DERANGEMENTS OF WOUND HEALING - p. 69 46. METHODS TO IMPROVE WOUND HEALING - p. 70 47. CONCLUSION - p. 71 48. 5 Understanding Data and Interpreting the Literature - p. 72 49. INTRODUCTION - p. 72 50. HOW TO IDENTIFY ARTICLES WORTH READING - p. 72 51. FIVE BASIC QUESTIONS FOR INTERPRETING DATA - p. 73 52. THE FUTURE OF UNDERSTANDING DATA - p. 87 53. 6 Outcomes Research and Evidence-Based Medicine - p. 90 54. INTRODUCTION AND HISTORY - p. 90 55. DEFINITION OF OUTCOME - p. 90 56. TYPES OF STUDIES - p. 90 57. STEPS IN PERFORMING OUTCOMES RESEARCH - p. 91 58. RESULTS FROM OUTCOMES RESEARCH IN OTOLARYNGOLOGY - p. 93 59. OTHER TYPES OF OUTCOMES RESEARCH - p. 93 60. EVIDENCE-BASED MEDICINE - p. 94 61. EVIDENCE-BASED GUIDELINES - p. 97 62. 7 Introduction to Otolaryngic Genetics - p. 99 63. INTRODUCTION - p. 99 64. MOLECULAR BASIS OF INHERITANCE - p. 99 65. MENDELIAN GENETICS - p. 104 66. NONMENDELIAN GENETICS - p. 107 67. GENETIC DISORDERS IN OTOLARYNGOLOGY—HEAD AND NECK SURGERY - p. 114 68. DIAGNOSIS OF GENETIC DISORDERS - p. 118 69. MOLECULAR THERAPY IN GENETICS - p. 118 70. ACKNOWLEDGMENTS - p. 119 71. 8 Head and Neck Imaging - p. 124 72. INTRODUCTION - p. 124 73. IMAGING MODALITIES - p. 124 74. IMAGING APPLICATIONS BASED ON ANATOMIC LOCATION - p. 132 75. NEWER IMAGING MODALITIES AND THEIR APPLICATIONS - p. 144 76. CONCLUSION - p. 145 77. 9 Surgical Pathology in Otolaryngologic Practice - p. 148 78. INTRODUCTION - p. 148 79. THE PATHOLOGY LABORATORY - p. 148 80. BIOPSY TECHNIQUES - p. 148 81. PATHOLOGY AND THE OPERATING ROOM - p. 151 82. INTRAOPERATIVE CONSULTATION - p. 153 83. NECK DISSECTION SPECIMENS - p. 154 84. HEAD AND NECK HISTOPATHOLOGY - p. 155 85. SQUAMOUS CELL CARCINOMA AND ITS VARIANTS - p. 167 86. 10 Neurology in Otolaryngology - p. 171 87. INTRODUCTION - p. 171 88. ANATOMY AND CRANIAL NERVE FUNCTIONS - p. 171 89. CEREBROVASCULAR DISEASE - p. 171 90. MIGRAINE - p. 177 91. NEUROMUSCULAR DISORDERS - p. 181 92. NEOPLASMS - p. 185 93. CHIARI MALFORMATION - p. 186 94. NORMAL PRESSURE HYDROCEPHALUS - p. 187 95. 11 Ophthalmic Considerations for Otolaryngology—Head and Neck Surgery - p. 189 96. INTRODUCTION - p. 189 97. THE BASIC EYE EXAMINATION - p. 189 98. ORBITAL TRAUMA - p. 192 99. SINO-ORBITAL INFECTIONS AND INFLAMMATIONS - p. 193 100. NONINFECTIOUS ORBITAL INFLAMMATION - p. 196 101. SINO-ORBITAL NEOPLASMS - p. 198 102. LACRIMAL SURGERY - p. 198 103. OPHTHALMIC COMPLICATIONS OF FACIAL NERVE PALSY - p. 198 104. SYNDROMES OF HEARING AND VISUAL DYSFUNCTION - p. 199 105. 12 Anesthesiology - p. 203 106. INTRODUCTION - p. 203 107. PREOPERATIVE PREPARATION - p. 203 108. AIRWAY MANAGEMENT - p. 203 109. GENERAL ANESTHESIA - p. 207 110. ANCILLARY AGENTS - p. 210 111. LOCAL ANESTHESIA - p. 213 112. ANESTHESIA MONITORING - p. 215 113. ANESTHETIC CONSIDERATIONS FOR ENDOSCOPIC PROCEDURES - p. 216 114. 13 Endocrinology - p. 220 115. INTRODUCTION - p. 220 116. PITUITARY GLAND - p. 220 117. THE PARATHYROID GLAND AND CALCIUM HOMEOSTASIS - p. 223 118. THYROID GLAND - p. 229 119. ADRENAL GLANDS - p. 232 120. THE PANCREAS AND GLUCOSE METABOLISM - p. 234 121. INHERITED ENDOCRINE DISORDERS - p. 236 122. HORMONE SECRETING TUMORS - p. 237 123. 14 Basic Concepts in Geriatric Otolaryngology - p. 242 124. INTRODUCTION - p. 242 125. CONCEPTS IN AGING - p. 242 126. 15 Complementary/Integrative Medicine - p. 248 127. INTRODUCTION - p. 248 128. TYPES OF CIM - p. 248 129. CIM FOR THE OTOLARYNGOLOGIST - p. 252 130. COMMONLY USED CIM THERAPIES FOR OTOLARYNGOLOGIC CONDITIONS - p. 255 131. CONCLUSION - p. 258 132. 16 Tobacco Cessation: How-to Guidance and Resources for Practitioners - p. 263 133. BACKGROUND - p. 263 134. THE CLINICAL INTERVENTION - p. 264 135. BRIEF CLINICAL INTERVENTION - p. 264 136. MULTIMODALITY TREATMENT - p. 267 137. CESSATION PROGRAMS AND RESOURCES - p. 270 138. SMOKING CESSATION FOR THE SURGEON—PERIOPERATIVE CONSIDERATIONS - p. 271 139. CONCLUSION - p. 272 140. 17 Palliative Care and Pain Management - p. 275 141. INTRODUCTION - p. 275 142. PRESENTING SYMPTOMS AND ASSESSMENT OF PATIENTS WITH HNC - p. 276 143. PALLIATIVE ANTINEOPLASTIC THERAPIES - p. 277 144. PALLIATIVE CARE CLINICAL PRACTICE GUIDELINES - p. 278 145. PAIN IN HEAD AND NECK CANCER - p. 280 146. END-OF-LIFE CARE FOR PATIENTS WITH HNC - p. 286 147. CARE FOR THE CAREGIVER AND PHYSICIAN BURNOUT - p. 288 148. CONCLUSION - p. 289 149. 18 Global Respiratory Infections - p. 293 150. INTRODUCTION - p. 293 151. COVID-19 VIROLOGY AND AFFINITY FOR THE NASAL CAVITY AND NASOPHARYNX - p. 293 152. DISEASE TRANSMISSION - p. 294 153. CLINICAL FEATURES AND DIAGNOSIS - p. 295 154. CONSIDERATIONS FOR PRACTICE - p. 295 155. VIRAL-ASSOCIATED OLFACTORY LOSS - p. 296 156. COVID-19 IN CHILDREN AND MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) - p. 296 157. CONCLUSION - p. 297 158. SECTION II: RHINOLOGY AND ALLERGY - p. 299 159. 19 Sinonasal Anatomy and Physiology - p. 301 160. EMBRYOLOGY - p. 301 161. ANATOMY - p. 301 162. ANATOMIC CAUSES OF NASAL OBSTRUCTION - p. 305 163. PHYSIOLOGY - p. 307 164. 20 Olfaction - p. 313 165. INTRODUCTION - p. 313 166. ANATOMY - p. 313 167. PHYSIOLOGY OF OLFACTION - p. 315 168. ETIOLOGY OF OLFACTORY LOSS - p. 315 169. EVALUATION - p. 316 170. PHANTOSMIA/DYSOSMIA CONSIDERATIONS - p. 318 171. TREATMENT - p. 319 172. 21 Immunology and Allergy - p. 323 173. INTRODUCTION - p. 323 174. THE UNIFIED AIRWAY - p. 323 175. THE IMMUNE RESPONSE - p. 323 176. INNATE AND ADAPTIVE IMMUNITY - p. 324 177. THE LINK BETWEEN THE INNATE AND ADAPTIVE IMMUNE SYSTEM - p. 326 178. CELLS OF THE IMMUNE SYSTEM - p. 327 179. IMMUNOGLOBULINS - p. 332 180. CYTOKINES, INTERFERONS, AND CHEMOKINES - p. 333 181. DEVELOPMENT OF ALLERGY - p. 333 182. THE NEURAL COMPONENT OF ALLERGY - p. 346 183. CONCLUSION - p. 347 184. 22 Allergy Testing - p. 355 185. INTRODUCTION - p. 355 186. ALLERGY TESTING ACCURACY - p. 355 187. SELECTING ALLERGENS FOR TESTING - p. 356 188. ALLERGY SKIN TESTING - p. 358 189. INTERPRETING ALLERGY TESTING - p. 363 190. CONCLUSIONS - p. 363 191. 23 The Role of Imaging in the Management of Sinonasal Disease - p. 366 192. INTRODUCTION - p. 366 193. INDICATIONS FOR SINUS CT AND MRI - p. 366 194. IMAGING TECHNIQUES - p. 366 195. IMAGING APPROACH - p. 369 196. CONCLUSION - p. 388 197. 24 Diagnostic Tools for Sinonasal Disease - p. 390 198. INTRODUCTION - p. 390 199. RIGID SINONASAL ENDOSCOPY - p. 390 200. RADIOLOGIC INVESTIGATIONS - p. 391 201. LABORATORY INVESTIGATIONS - p. 394 202. ALLERGY TESTING - p. 396 203. OLFACTORY TESTING - p. 398 204. NASAL AIRWAY PATENCY EVALUATION - p. 400 205. CILIARY TESTING - p. 401 206. TISSUE SAMPLING FOR PATHOLOGIC DIAGNOSIS - p. 402 207. 25 Allergic Rhinitis - p. 405 208. INTRODUCTION - p. 405 209. DEFINITION AND GENETICS - p. 405 210. BASIC IMMUNOLOGY OF ALLERGY - p. 405 211. EPIDEMIOLOGY - p. 405 212. DIAGNOSIS - p. 406 213. TREATMENT - p. 409 214. CONCLUSION - p. 412 215. 26 Nonallergic Rhinitis - p. 416 216. INTRODUCTION - p. 416 217. EPIDEMIOLOGY AND SOCIAL IMPACT - p. 416 218. PHYSIOLOGY - p. 417 219. CLASSIFICATION - p. 417 220. IDIOPATHIC RHINITIS - p. 418 221. NONALLERGIC RHINITIS WITH EOSINOPHILIA SYNDROME - p. 421 222. WORK-RELATED RHINITIS (OCCUPATIONAL RHINITIS) - p. 422 223. DRUG-INDUCED RHINITIS - p. 424 224. HORMONE-INDUCED RHINITIS - p. 429 225. Autonomic Rhinitis (Vasomotor Rhinitis)1 - p. 430 226. ATROPHIC RHINITIS - p. 430 227. SYSTEMIC CAUSES OF NONALLERGIC RHINITIS - p. 432 228. AGING AND RHINITIS - p. 433 229. 27 Systemic Diseases That Affect the Nose and Sinuses - p. 439 230. INTRODUCTION - p. 439 231. CONGENITAL/GENETIC - p. 439 232. GRANULOMATOUS - p. 441 233. AUTOIMMUNE - p. 443 234. HEMATOLOGIC - p. 447 235. OTHER - p. 449 236. 28 Epistaxis - p. 452 237. EPIDEMIOLOGY - p. 452 238. VASCULAR ANATOMY OF THE NOSE - p. 454 239. CLINICAL MANAGEMENT - p. 455 240. MANAGEMENT OF COMORBID SYSTEMIC FACTORS - p. 458 241. SURGICAL MANAGEMENT - p. 459 242. ENDOVASCULAR EMBOLIZATION - p. 461 243. 29 Acute Rhinosinusitis - p. 463 244. ABSTRACT - p. 463 245. DEFINING RHINOSINUSITIS - p. 463 246. EPIDEMIOLOGY - p. 464 247. PATHOPHYSIOLOGY AND MICROBIOLOGY - p. 465 248. CLINICAL PRESENTATION AND EVALUATION - p. 468 249. IMAGING - p. 469 250. TREATMENT - p. 471 251. COMPLICATIONS - p. 474 252. SPECIAL CONSIDERATIONS IN THE PEDIATRIC POPULATION - p. 477 253. CONCLUSION - p. 477 254. 30 Chronic Rhinosinusitis with Nasal Polyposis - p. 482 255. INTRODUCTION - p. 482 256. EPIDEMIOLOGY OF NASAL POLYP DISEASE - p. 482 257. CLINICAL PRESENTATION AND DIAGNOSIS - p. 483 258. SEVERITY CLASSIFICATION IN NASAL POLYP DISEASE - p. 486 259. HISTOPATHOLOGY - p. 486 260. PATHOPHYSIOLOGY - p. 486 261. NASAL POLYPS AND ALLERGY - p. 488 262. NASAL POLYPS AND ASTHMA - p. 488 263. ASPIRIN-EXACERBATED RESPIRATORY DISEASE - p. 489 264. NASAL POLYPS AND FUNGI - p. 489 265. CYSTIC FIBROSIS - p. 490 266. CONCLUSION - p. 490 267. 31 Chronic Nonpolypoid Rhinosinusitis: Pathogenesis, Diagnosis, Staging, and Treatment - p. 494 268. INTRODUCTION - p. 494 269. PATHOPHYSIOLOGY - p. 494 270. DIAGNOSIS - p. 499 271. STAGING - p. 502 272. DIAGNOSTIC CORRELATES - p. 502 273. TREATMENT - p. 503 274. 32 The Unified Airway - p. 509 275. INTRODUCTION - p. 509 276. ALLERGIC RHINITIS - p. 509 277. CHRONIC RHINOSINUSITIS - p. 510 278. ASTHMA - p. 510 279. OTHER UNIFIED AIRWAY CONDITIONS - p. 511 280. EVIDENCE FOR THE UNIFIED AIRWAY - p. 512 281. CONCLUSIONS - p. 515 282. 33 Fungal Rhinosinusitis - p. 518 283. FUNGAL RHINOSINUSITIS - p. 518 284. ACUTE INVASIVE FUNGAL RHINOSINUSITIS - p. 519 285. CLINICAL PRESENTATION - p. 524 286. DIAGNOSIS - p. 524 287. IMAGING - p. 524 288. TREATMENT AND PROGNOSIS - p. 525 289. PATHOLOGY - p. 526 290. TREATMENT AND PROGNOSIS - p. 526 291. CLINICAL PRESENTATION - p. 527 292. RADIOLOGY - p. 527 293. PATHOLOGY - p. 527 294. TREATMENT - p. 528 295. CLINICAL PRESENTATION - p. 528 296. DIAGNOSIS - p. 529 297. RADIOLOGY - p. 529 298. PATHOLOGY - p. 530 299. FUNGAL CULTURE - p. 531 300. THEORIES AND CONTROVERSIES SURROUNDING PATHOGENESIS - p. 531 301. TREATMENT - p. 532 302. 34 Complications of Rhinosinusitis - p. 535 303. INTRODUCTION - p. 535 304. ORBITAL COMPLICATIONS - p. 535 305. PRESEPTAL CELLULITIS - p. 537 306. ORBITAL CELLULITIS - p. 537 307. SUBPERIOSTEAL ABSCESS - p. 538 308. ORBITAL ABSCESS - p. 539 309. CAVERNOUS SINUS THROMBOSIS - p. 539 310. EVALUATION AND DIAGNOSIS - p. 539 311. INTRACRANIAL COMPLICATIONS - p. 542 312. EPIDURAL ABSCESS - p. 544 313. SUBDURAL ABSCESS - p. 544 314. INTRACEREBRAL ABSCESS - p. 545 315. VENOUS SINUS THROMBOSIS - p. 545 316. MENINGITIS - p. 545 317. MICROBIOLOGY AND TREATMENT OF INTRACRANIAL COMPLICATIONS - p. 545 318. BONY COMPLICATIONS - p. 547 319. PREVENTION OF COMPLICATIONS OF SINUSITIS - p. 547 320. 35 Medical Management of Chronic Sinusitis - p. 550 321. INTRODUCTION - p. 550 322. DEFINITION AND DIAGNOSIS - p. 550 323. STAGING SYSTEMS - p. 551 324. MEDICAL MANAGEMENT OF CHRONIC RHINOSINUSITIS - p. 551 325. CONCLUSION - p. 557 326. 36 Endoscopic Sinus Surgery for Chronic Rhinosinusitis - p. 561 327. INTRODUCTION - p. 561 328. PREPARATION FOR SURGERY - p. 561 329. SURGICAL TECHNIQUE - p. 563 330. MAXILLARY SINUS— Video 36.1 - p. 564 331. ETHMOID CAVITY— Video 36.2 - p. 565 332. ANTERIOR ETHMOIDECTOMY - p. 565 333. CONCHA BULLOSA— Video 36.3 - p. 566 334. POSTERIOR ETHMOIDECTOMY - p. 566 335. SPHENOID SINUS— Video 36.5 - p. 567 336. BALLOON SINUPLASTY - p. 568 337. REVISION SURGERY - p. 568 338. MAXILLARY SINUS - p. 569 339. ETHMOID CAVITY - p. 569 340. SPHENOID SINUS - p. 569 341. OUTCOMES OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY - p. 570 342. CONCLUSION - p. 570 343. 37 External Approaches in Sinus Surgery - p. 572 344. INTRODUCTION - p. 572 345. MAXILLARY SINUSES - p. 572 346. FRONTAL SINUSES - p. 573 347. ETHMOID SINUSES - p. 578 348. SPHENOID SINUS - p. 578 349. CONCLUSIONS - p. 579 350. 38 Septoplasty, Turbinate Reduction, and Correction of Nasal Obstruction - p. 581 351. EVALUATION AND ASSESSMENT - p. 581 352. DEVIATED NASAL SEPTUM - p. 583 353. INDICATIONS - p. 583 354. TURBINATE REDUCTION - p. 586 355. NASAL VALVE OBSTRUCTION - p. 588 356. CONCLUSION - p. 589 357. 39 Endoscopic Orbital Surgery - p. 591 358. INTRODUCTION - p. 591 359. ANATOMY - p. 591 360. EPIPHORA AND ENDOSCOPIC DACRYOCYSTORHINOSTOMY - p. 594 361. ENDOSCOPIC ORBITAL AND OPTIC NERVE DECOMPRESSION - p. 596 362. ENDOSCOPIC MANAGEMENT OF ORBITAL NEOPLASMS - p. 599 363. TRANSORBITAL NEUROENDOSCOPIC SURGERY (TONES) - p. 604 364. 40 Endoscopic Approaches to the Anterior Ventral Skull Base - p. 607 365. INTRODUCTION - p. 607 366. PATIENT SELECTION AND INDICATIONS - p. 607 367. DIAGNOSTIC WORK-UP - p. 608 368. SURGICAL ANATOMY - p. 611 369. SURGICAL TECHNIQUE - p. 611 370. POSTOPERATIVE CARE - p. 615 371. COMPLICATIONS - p. 615 372. FUTURE PERSPECTIVES - p. 616 373. CONCLUSION - p. 617 374. 41 Endoscopic Evaluation and Treatment of CSF Leaks - p. 620 375. HISTORY OF CSF LEAK SURGERY - p. 620 376. CSF PHYSIOLOGY AND INTRACRANIAL PRESSURE BASICS - p. 620 377. ETIOLOGY - p. 620 378. PATIENT WORKUP - p. 624 379. PERIOPERATIVE ISSUES - p. 625 380. SURGICAL MANAGEMENT - p. 626 381. SITE-SPECIFIC REPAIR STRATEGY - p. 627 382. RECONSTRUCTIVE TECHNIQUES - p. 628 383. POSTOPERATIVE CARE - p. 629 384. LONG-TERM MANAGEMENT - p. 629 385. OUTCOMES - p. 630 386. 42 Frontal Sinus Surgery - p. 632 387. INTRODUCTION - p. 632 388. INDICATIONS FOR FRONTAL SINUS SURGERY IN CHRONIC RHINOSINUSITIS - p. 632 389. SURGICAL ANATOMY—THE NEW INTERNATIONAL FRONTAL SINUS ANATOMY CLASSIFICATION - p. 633 390. THE BUILDING BLOCK CONCEPT FOR A 3D UNDERSTANDING OF THE FRONTAL RECESS - p. 633 391. COMPLEXITY OF THE FRONTAL RECESS ANATOMY - p. 638 392. FRONTAL SINUS SURGERY AND OUTCOMES OF THE FRONTAL DRILL-OUT/MODIFIED LOTHROP - p. 638 393. AXILLARY FLAP - p. 639 394. MINI-TREPHINATION - p. 640 395. IMAGE-GUIDED SURGERY - p. 640 396. POSTOPERATIVE CARE - p. 643 397. CONTROVERSIES IN FRONTAL SINUS SURGERY - p. 643 398. SECTION III: COMPREHENSIVE OTOLARYNGOLOGY - p. 645 399. 43 Anatomy and Physiology of the Salivary Glands - p. 647 400. INTRODUCTION - p. 647 401. EMBRYOLOGY - p. 647 402. PHYSIOLOGY OF THE SALIVARY GLAND - p. 653 403. IMAGING - p. 655 404. SIALENDOSCOPY - p. 656 405. 44 Nonneoplastic Diseases of the Salivary Glands - p. 658 406. INTRODUCTION - p. 658 407. ACUTE INFLAMMATORY LESIONS - p. 658 408. GRANULOMATOUS INFECTIONS OF THE SALIVARY GLANDS - p. 660 409. RADIATION INJURY - p. 667 410. OTHER DISORDERS - p. 669 411. COMPLICATIONS - p. 669 412. 45 Taste - p. 673 413. INTRODUCTION - p. 673 414. DEVELOPMENT OF THE TASTE SYSTEM - p. 673 415. ANATOMY OF THE TASTE SYSTEM - p. 673 416. TASTE TRANSDUCTION - p. 674 417. INNERVATION OF THE TONGUE - p. 674 418. TASTE TESTING AND BACKGROUND - p. 675 419. VIDEOMICROSCOPY (VM) - p. 676 420. TASTE ALTERING CONDITIONS - p. 676 421. EFFECTS OF TASTE LOSS - p. 678 422. THERAPY FOR TASTE LOSS - p. 678 423. CONCLUSION - p. 678 424. ACKNOWLEDGMENT - p. 678 425. 46 Stomatitis - p. 680 426. INTRODUCTION - p. 680 427. CLINICAL ASSESSMENT - p. 680 428. ETIOLOGY - p. 681 429. TREATMENT-RELATED STOMATITIS - p. 681 430. INFECTIOUS - p. 683 431. IMMUNOLOGIC - p. 687 432. SYSTEMIC CONDITIONS - p. 690 433. NUTRITIONAL - p. 692 434. IDIOPATHIC - p. 692 435. STOMATITIS UNIQUE TO CHILDHOOD - p. 696 436. MULTIFACTORIAL - p. 697 437. SUMMARY - p. 697 438. ACKNOWLEDGMENTS - p. 697 439. 47 Pharyngitis - p. 700 440. INTRODUCTION - p. 700 441. ANATOMY - p. 700 442. INFECTIOUS CAUSES OF PHARYNGITIS IN THE CHILD - p. 701 443. INFECTIOUS CAUSES OF PHARYNGITIS IN THE ADULT - p. 706 444. 48 Odontogenic Infections - p. 713 445. INTRODUCTION - p. 713 446. DEMOGRAPHICS - p. 713 447. MICROBIOLOGY - p. 713 448. SPREAD OF LOCALIZED INFECTIONS - p. 714 449. CANINE SPACE INFECTIONS - p. 716 450. BUCCAL SPACE INFECTIONS - p. 716 451. MASTICATOR SPACE INFECTIONS - p. 717 452. MANDIBULAR SPACES - p. 717 453. LUDWIG ANGINA - p. 720 454. GENERAL TREATMENT GUIDELINES - p. 721 455. COMPLICATIONS OF ODONTOGENIC INFECTIONS - p. 722 456. 49 Lymphoid Hypertrophy and Lymphadenopathy - p. 725 457. INTRODUCTION - p. 725 458. ANATOMY OF A LYMPH NODE AND LYMPHOID TISSUES - p. 725 459. OVERVIEW OF NECK LEVELS AND LYMPHATIC DRAINAGE OF THE NECK - p. 726 460. LYMPHOID HYPERTROPHY AND REACTIVE LYMPHADENOPATHY - p. 731 461. AUTOIMMUNE, METABOLIC, AND IDIOPATHIC LYMPHADENOPATHY - p. 733 462. NEOPLASTIC LYMPHADENOPATHY - p. 735 463. HIV-ASSOCIATED LYMPHADENOPATHY AND LYMPHOID HYPERTROPHY - p. 736 464. CONCLUSION - p. 736 465. 50 Headache and Facial Pain - p. 739 466. INTRODUCTION - p. 739 467. BACKGROUND - p. 739 468. DIFFERENTIAL DIAGNOSIS - p. 741 469. PATIENT EVALUATION AND WORKUP - p. 746 470. CONCLUSION - p. 747 471. 51 Diagnosis and Management of Temporomandibular Joint Spectrum Diseases - p. 749 472. INTRODUCTION - p. 749 473. ANATOMY AND PHYSIOLOGY OF THE TMJ - p. 749 474. FOCUSED HISTORY AND PHYSICAL EXAMINATION - p. 751 475. DIAGNOSTIC IMAGING OF THE TEMPOROMANDIBULAR JOINT - p. 752 476. CURRENT CLASSIFICATION SYSTEMS OF TEMPOROMANDIBULAR JOINT DISORDERS - p. 753 477. PATHOPHYSIOLOGY - p. 754 478. MANAGEMENT - p. 755 479. CONCLUSION - p. 758 480. 52 Systemic Disease Manifestations in the Head and Neck - p. 761 481. INTRODUCTION - p. 761 482. VASCULITIDES (TABLE 52.1) - p. 761 483. GRANULOMATOUS DISEASE - p. 764 484. RHEUMATOLOGIC AND AUTOIMMUNE DISEASE (TABLE 52.3) - p. 765 485. CONCLUSION - p. 772 486. 53 Soft Tissue Infections of the Head and Neck - p. 774 487. INTRODUCTION - p. 774 488. ETIOLOGY - p. 774 489. FASCIAL ORGANIZATION OF THE HEAD AND NECK - p. 774 490. DEEP NECK SPACE ANATOMY - p. 778 491. BACTERIOLOGY - p. 782 492. DIAGNOSIS - p. 782 493. MANAGEMENT - p. 784 494. COMPLICATIONS - p. 786 495. SPECIAL CONSIDERATIONS - p. 788 496. SPECIFIC DEEP NECK SPACE INFECTIONS - p. 789 497. SECTION IV: LARYNGOLOGY - p. 799 498. 54 Swallowing Anatomy and Physiology - p. 801 499. INTRODUCTION - p. 801 500. ANTICIPATORY PHASE - p. 802 501. ORAL PREPARATORY PHASE - p. 802 502. ORAL TRANSFER PHASE - p. 803 503. PHARYNGEAL PHASE - p. 804 504. ESOPHAGEAL PHASE - p. 806 505. BREATHING AND SWALLOWING COORDINATION - p. 807 506. CONCLUSION - p. 807 507. 55 Functional Assessment of Swallowing - p. 809 508. INTRODUCTION - p. 809 509. DYSPHAGIA SYMPTOM INDICES - p. 809 510. CLINICAL SWALLOW EVALUATION - p. 810 511. FLEXIBLE ENDOSCOPIC EXAMINATION OF SWALLOWING/FLEXIBLE ENDOSCOPIC EVALUATION OF SWALLOWING WITH SENSORY TESTING - p. 812 512. VIDEOFLUOROSCOPIC SWALLOW STUDY - p. 815 513. TRANSNASAL ESOPHAGOSCOPY - p. 815 514. HIGH-RESOLUTION PHARYNGEAL MANOMETRY - p. 818 515. 56 Nonsurgical Management of Swallowing Disorders - p. 823 516. INTRODUCTION - p. 823 517. COMPENSATORY TREATMENT PROCEDURES - p. 824 518. THERAPY PROCEDURES - p. 826 519. MEDICAL MANAGEMENT - p. 829 520. CONCLUSION - p. 831 521. 57 Surgical Management of Swallowing Disorders - p. 835 522. INTRODUCTION - p. 835 523. NASOPHARYNX - p. 835 524. PHARYNX/LARYNX - p. 836 525. ESOPHAGUS - p. 837 526. NEOPLASMS OF THE ESOPHAGUS - p. 841 527. ESOPHAGEAL PERFORATION - p. 842 528. TRACHEOTOMY AND DYSPHAGIA - p. 842 529. END-STAGE DYSPHAGIA - p. 842 530. 58 Esophageal Disorders: Evaluation and Management - p. 846 531. INTRODUCTION - p. 846 532. INFLAMMATORY ESOPHAGEAL DISORDERS - p. 846 533. AUTOIMMUNE ESOPHAGEAL DISORDERS - p. 850 534. MOTILITY DISORDERS - p. 850 535. STRUCTURAL DISORDERS - p. 854 536. ANATOMIC OBSTRUCTION - p. 855 537. NEOPLASTIC DISEASE - p. 857 538. ESOPHAGEAL EMERGENCIES - p. 857 539. SUMMARY - p. 858 540. 59 Upper Airway Anatomy and Function - p. 861 541. PHARYNGEAL ANATOMY - p. 861 542. PHARYNGEAL AIRWAY PHYSIOLOGY - p. 862 543. LARYNGEAL ANATOMY - p. 863 544. RESPIRATORY PHYSIOLOGY OF THE LARYNX - p. 867 545. SPEECH - p. 869 546. 60 Upper Airway Disorders: Cough and Inducible Laryngeal Obstruction - p. 872 547. INTRODUCTION - p. 872 548. CHRONIC COUGH - p. 872 549. INDUCIBLE LARYNGEAL OBSTRUCTION - p. 878 550. 61 Advanced Airway Management: Intubation - p. 888 551. HISTORY OF INTUBATION - p. 888 552. INDICATIONS FOR ENDOTRACHEAL INTUBATION - p. 888 553. CONTRAINDICATIONS FOR ENDOTRACHEAL INTUBATION - p. 888 554. AIRWAY MANAGEMENT PLANNING - p. 889 555. AIRWAY MANAGEMENT - p. 892 556. DIFFICULT AIRWAY MANAGEMENT - p. 906 557. THE COLLABORATIVE APPROACH TO SHARED AIRWAY SURGERY - p. 912 558. 62 The Surgical Airway - p. 919 559. INTRODUCTION (HISTORY) - p. 919 560. INDICATIONS FOR TRACHEOTOMY - p. 920 561. SURGICAL AIRWAY TECHNIQUES - p. 921 562. COMPLICATIONS - p. 933 563. PERCUTANEOUS DILATATIONAL TRACHEOTOMY IN THE INTENSIVE CARE UNIT - p. 936 564. TRACHEOTOMY IN THE ERA OF COVID-19: SPECIAL CONSIDERATIONS - p. 944 565. CONCLUSION - p. 945 566. 63 Upper Airway Restriction: Evaluation and Management - p. 947 567. INTRODUCTION - p. 947 568. ETIOLOGY OF OBSTRUCTION - p. 947 569. EVALUATION - p. 951 570. NONOPERATIVE MANAGEMENT - p. 953 571. SUPRAGLOTTIC STENOSIS - p. 953 572. GLOTTIC STENOSIS - p. 953 573. BILATERAL TRUE VOCAL FOLD PARALYSIS - p. 955 574. SUBGLOTTIC AND TRACHEAL STENOSIS - p. 956 575. SOLUTIONS FOR EXTENDED LENGTH TRACHEAL STENOSIS - p. 963 576. 64 Laryngeal Trauma - p. 972 577. INTRODUCTION - p. 972 578. PATHOPHYSIOLOGY OF LARYNGEAL INJURIES - p. 972 579. DIAGNOSIS AND EVALUATION - p. 973 580. MANAGEMENT - p. 975 581. COMPLICATIONS - p. 980 582. CONCLUSION - p. 982 583. 65 Voice: Anatomy, Physiology, and Clinical Evaluation - p. 984 584. INTRODUCTION - p. 984 585. ANATOMY - p. 984 586. PHYSIOLOGY - p. 990 587. EVALUATION - p. 992 588. CONCLUSION - p. 994 589. 66 Laryngopharyngeal Reflux - p. 997 590. INTRODUCTION - p. 997 591. REVIEW OF GASTRIC REFLUX CONTENTS AND PHYSIOLOGY - p. 997 592. PATHOPHYSIOLOGY OF LPR - p. 1000 593. OTHER CLINICAL MANIFESTATIONS OF EER - p. 1002 594. DIAGNOSIS - p. 1003 595. TREATMENT OF LARYNGOPHARYNGEAL REFLUX - p. 1008 596. MEDICAL TREATMENT - p. 1010 597. SURGICAL MANAGEMENT OF REFLUX - p. 1012 598. CONCLUSION - p. 1013 599. 67 Infection, Infiltration, and Benign Neoplasms of the Larynx - p. 1018 600. INTRODUCTION - p. 1018 601. INFECTIONS OF THE LARYNX - p. 1018 602. INFILTRATIVE AND INFLAMMATORY DISEASES OF THE LARYNX - p. 1021 603. BENIGN NEOPLASMS OF THE LARYNX - p. 1025 604. LARYNGOCELES AND SACCULAR CYSTS - p. 1028 605. SUMMARY - p. 1030 606. 68 Benign Vocal Fold Lesions and Phonomicrosurgery - p. 1034 607. INTRODUCTION - p. 1034 608. BENIGN EPITHELIAL LESIONS OF THE VOCAL FOLD - p. 1034 609. BENIGN LESIONS OF THE VOCAL FOLD LAMINA PROPRIA - p. 1035 610. PHONOMICROSURGERY OF THE VOCAL FOLDS - p. 1041 611. PHONOMICROSURGERY PROCEDURES, TECHNIQUES, AND METHODS - p. 1043 612. COMPLICATIONS - p. 1047 613. 69 Treatment of Unilateral Vocal Fold Paralysis and Paresis - p. 1049 614. INTRODUCTION - p. 1049 615. UNILATERAL VOCAL FOLD PARALYSIS - p. 1049 616. UNILATERAL VOCAL FOLD PARESIS - p. 1061 617. SUMMARY - p. 1065 618. 70 Neurologic Disorders of the Larynx - p. 1070 619. INTRODUCTION - p. 1070 620. NEUROANATOMY AND THE LARYNX - p. 1070 621. GENERAL APPROACH TO DIAGNOSIS AND TREATMENT - p. 1073 622. DISORDERS AFFECTING THE CENTRAL NERVOUS SYSTEM - p. 1074 623. DISORDERS AFFECTING THE PERIPHERAL NERVOUS SYSTEM - p. 1082 624. 71 Therapy for Voice Disorders - p. 1089 625. ASSESSING CANDIDACY FOR VOICE THERAPY - p. 1089 626. A FRAMEWORK FOR VOICE THERAPY - p. 1090 627. VOICE THERAPY TECHNIQUES AND PROGRAMS: THEORETICAL RATIONALE - p. 1090 628. WHEN TO DISCHARGE FROM VOICE THERAPY? - p. 1092 629. 72 Care of the Professional Voice - p. 1095 630. INTRODUCTION - p. 1095 631. HARMONIC SOUND SOURCE AND THE SOURCE FILTER THEORY OF SOUND PRODUCTION - p. 1095 632. PERFORMANCE STYLES - p. 1099 633. PATHOPHYSIOLOGY - p. 1099 634. EVALUATION OF THE PATIENT WITH VOCAL DIFFICULTIES - p. 1101 635. REFLUX - p. 1105 636. MANAGEMENT - p. 1105 637. ACUTE CARE FOR THE EMERGENT VOCAL PROBLEM - p. 1106 638. SURGICAL MANAGEMENT - p. 1107 639. CONCLUSION - p. 1107 640. 73 Special Considerations: Aging Voice, Gender Affirming Voice and Laryngeal Care, and Variants of Muscle Tension Dysphonia - p. 1110 641. AGING VOICE - p. 1110 642. GENDER AFFIRMING VOICE AND LARYNGEAL CARE - p. 1113 643. VARIANTS OF MUSCLE TENSION DYSPHONIA - p. 1117 644. ACKNOWLEDGMENT - p. 1121 645. 74 Awake Procedures in Laryngology - p. 1125 646. INTRODUCTION - p. 1125 647. LARYNGEAL VISUALIZATION - p. 1125 648. PATIENT SELECTION AND PREPARATION - p. 1125 649. ANESTHESIA - p. 1126 650. MONITORING DURING AWAKE LARYNGEAL PROCEDURES - p. 1127 651. AIRWAY EVALUATION AND ASSESSMENT - p. 1128 652. LARYNGOPHARYNGEAL BIOPSY, PANENDOSCOPY, AND TUMOR STAGING - p. 1128 653. VOCAL FOLD INJECTION - p. 1128 654. LASER PROCEDURES - p. 1133 655. SERIAL INTRALESIONAL STEROID INJECTIONS FOR SUBGLOTTIC STENOSIS - p. 1136 656. TRANSNASAL ESOPHAGOSCOPY - p. 1136 657. MISCELLANEOUS PROCEDURES - p. 1136 658. CONCLUSION - p. 1137 659. SECTION V: TRAUMA - p. 1141 660. 75 Principles of Trauma - p. 1143 661. INTRODUCTION - p. 1143 662. NEUROENDOCRINE RESPONSE - p. 1144 663. METABOLIC RESPONSE - p. 1144 664. TREATMENT OF A PATIENT WHO HAS SUSTAINED TRAUMA - p. 1144 665. ROLE OF THE OTOLARYNGOLOGIST - p. 1155 666. PRECAUTIONS IN THE COVID-19 PANDEMIC - p. 1155 667. 76 Management of Soft Tissue Injuries of the Face - p. 1158 668. INTRODUCTION - p. 1158 669. ETIOLOGY AND MECHANISM OF INJURY - p. 1158 670. EVALUATION - p. 1158 671. WOUND CLASSIFICATION - p. 1159 672. WOUND MANAGEMENT - p. 1160 673. LACERATION REPAIR - p. 1162 674. INJURIES BY ANATOMICAL LOCATION - p. 1163 675. SPECIAL CONSIDERATIONS - p. 1177 676. 77 Penetrating Face and Neck Trauma - p. 1183 677. INTRODUCTION - p. 1183 678. GENERAL TRAUMA PRINCIPLES - p. 1183 679. PENETRATING FACIAL INJURIES - p. 1185 680. PENETRATING NECK INJURIES - p. 1188 681. PEDIATRIC PENETRATING INJURIES - p. 1193 682. 78 Principles in Rigid Fixation of the Facial Skeleton - p. 1195 683. INTRODUCTION - p. 1195 684. BONE HEALING - p. 1195 685. FRACTURE PATHOPHYSIOLOGY AND CLASSIFICATION - p. 1196 686. RATIONALE FOR RIGID FIXATION - p. 1197 687. BASIC PRINCIPLES OF RIGID FIXATION - p. 1197 688. FIXATION DEVICE CLASSIFICATION AND TERMINOLOGY - p. 1198 689. PRINCIPLES OF SCREW APPLICATION - p. 1198 690. LAG SCREW APPLICATION - p. 1199 691. PLATE APPLICATION - p. 1200 692. INSTRUMENTATION - p. 1201 693. FRACTURE REDUCTION - p. 1201 694. OCCLUSION - p. 1202 695. INCISIONS AND EXPOSURE - p. 1203 696. APPROACH TO PANFACIAL FRACTURES - p. 1204 697. SOFT TISSUE LOSS - p. 1210 698. COMPLICATIONS AND REVISIONS - p. 1210 699. 79 Surgical Approaches to the Craniofacial Skeleton - p. 1213 700. INTRODUCTION - p. 1213 701. UPPER ONE-THIRD—CRANIOFACIAL SKELETON - p. 1213 702. MIDFACIAL EXPOSURES - p. 1223 703. LOWER ONE-THIRD EXPOSURE—MANDIBLE - p. 1223 704. 80 Mandibular and Dental Fractures - p. 1229 705. INTRODUCTION - p. 1229 706. ANATOMY - p. 1229 707. BIOMECHANICS OF THE MANDIBLE - p. 1230 708. EVALUATION AND DIAGNOSIS - p. 1231 709. MANAGEMENT OF DENTAL FRACTURES - p. 1234 710. MANAGEMENT OF MANDIBLE FRACTURES - p. 1236 711. SPECIAL CONSIDERATIONS - p. 1239 712. COMPLICATIONS - p. 1242 713. INFECTED MANDIBLE FRACTURES - p. 1243 714. EMERGENCIES - p. 1243 715. FUTURE CONSIDERATIONS - p. 1243 716. 81 Midface Fractures - p. 1246 717. INTRODUCTION - p. 1246 718. MIDFACE ANATOMY - p. 1246 719. CLASSIFICATION OF MIDFACE FRACTURES - p. 1248 720. EPIDEMIOLOGY - p. 1250 721. PATIENT EVALUATION - p. 1250 722. COMPUTED TOMOGRAPHY - p. 1251 723. FRACTURE MANAGEMENT: BASIC PRINCIPLES - p. 1252 724. FRACTURE MANAGEMENT: SURGICAL TECHNIQUES - p. 1253 725. COMPLEX MIDFACE TRAUMA - p. 1259 726. TECHNICAL ADJUVANTS - p. 1259 727. POSTOPERATIVE CARE - p. 1261 728. COMPLICATIONS AND SEQUELAE - p. 1261 729. 82 Orbital and Naso-orbital-ethmoid Fractures - p. 1265 730. OVERVIEW - p. 1265 731. ANATOMY - p. 1265 732. DEMOGRAPHICS AND ETIOLOGY - p. 1267 733. EVALUATION - p. 1270 734. INDICATIONS FOR AND TIMING OF SURGICAL MANAGEMENT - p. 1272 735. SURGICAL TECHNIQUES - p. 1273 736. POSTOPERATIVE CARE - p. 1280 737. COMPLICATIONS - p. 1280 738. 83 Nasal Fractures - p. 1284 739. INTRODUCTION - p. 1284 740. ANATOMY - p. 1284 741. PATHOPHYSIOLOGY—MECHANISM OF INJURY - p. 1285 742. DIAGNOSTIC ASSESSMENT - p. 1288 743. MANAGEMENT - p. 1290 744. NASAL FRACTURES IN CHILDREN - p. 1294 745. SURGICAL TECHNIQUE - p. 1295 746. COMPLICATIONS - p. 1296 747. 84 Frontal Sinus Fractures - p. 1299 748. BACKGROUND - p. 1299 749. ANATOMY - p. 1299 750. EPIDEMIOLOGY - p. 1299 751. DIAGNOSIS - p. 1299 752. TREATMENT ALGORITHM - p. 1302 753. SURGICAL APPROACHES - p. 1306 754. TREATMENT STRATEGIES - p. 1313 755. COMPLICATIONS - p. 1323 756. SUMMARY - p. 1323 757. SECTION VI: PEDIATRIC OTOLARYNGOLOGY - p. 1327 758. 85 Developmental Considerations in Pediatric Otolaryngology - p. 1329 759. PATTERNS OF GROWTH AND DEVELOPMENT - p. 1329 760. SPEECH AND LANGUAGE DEVELOPMENT - p. 1336 761. AUTISM SPECTRUM DISORDER - p. 1338 762. CARE FOR THE PEDIATRIC PATIENT - p. 1339 763. CONCLUSION - p. 1340 764. ACKNOWLEDGEMENT - p. 1341 765. 86 Laryngeal Anomalies and Laryngotracheal Clefts - p. 1342 766. INTRODUCTION - p. 1342 767. EMBRYOLOGY - p. 1342 768. ANATOMY AND PHYSIOLOGY OF THE LARYNX - p. 1342 769. DIAGNOSIS - p. 1344 770. CONGENITAL LARYNGEAL ANOMALIES - p. 1347 771. CONCLUSION - p. 1355 772. 87 Congenital Anomalies of the Nose - p. 1358 773. INTRODUCTION - p. 1358 774. EMBRYOLOGY - p. 1358 775. CLINICAL AND PATHOLOGIC FEATURES - p. 1360 776. EVALUATION - p. 1363 777. SURGICAL TREATMENT - p. 1363 778. CONCLUSION - p. 1366 779. ACKNOWLEDGMENTS - p. 1366 780. 88 Tracheal and Bronchial Disorders in Children - p. 1367 781. INTRODUCTION - p. 1367 782. EMBRYOLOGY - p. 1367 783. ANATOMY AND PHYSIOLOGY - p. 1367 784. TRACHEOBRONCHOMALACIA - p. 1368 785. TRACHEOESOPHAGEAL FISTULA - p. 1372 786. LARYNGOTRACHEAL CLEFTS - p. 1373 787. TRACHEAL STENOSIS - p. 1373 788. COMPLETE TRACHEAL RINGS - p. 1374 789. TRACHEAL SLEEVE - p. 1375 790. TRACHEAL AGENESIS - p. 1376 791. TRACHEAL BRONCHUS AND ACCESSORY CARDIAC BRONCHUS - p. 1376 792. TRACHEAL DIVERTICULA AND POUCHES - p. 1377 793. ACQUIRED TRACHEAL STENOSIS - p. 1377 794. INHALATIONAL THERMAL INJURY - p. 1379 795. TRACHEOBRONCHIAL TRAUMA - p. 1380 796. TRACHEOBRONCHIAL NEOPLASMS - p. 1380 797. FRONTIERS OF TRACHEOBRONCHIAL SURGERY - p. 1381 798. CONCLUSION - p. 1381 799. 89 Neonatal Respiratory Distress - p. 1384 800. INTRODUCTION - p. 1384 801. ANATOMY AND PHYSIOLOGY - p. 1384 802. EVALUATION - p. 1384 803. EMERGENCY AIRWAY MANAGEMENT - p. 1386 804. NASAL OBSTRUCTION - p. 1387 805. ORAL CAVITY, OROPHARYNX, HYPOPHARYNX OBSTRUCTION - p. 1388 806. LARYNGEAL OBSTRUCTION - p. 1389 807. TRACHEAL AND BRONCHIAL OBSTRUCTION - p. 1391 808. CONGENITAL HIGH AIRWAY OBSTRUCTION - p. 1392 809. PRENATAL FETAL ASSESSMENT - p. 1392 810. EXIT PROCEDURE - p. 1393 811. CONCLUSION - p. 1393 812. 90 Ankyloglossia and Other Oral Frenula - p. 1396 813. INTRODUCTION - p. 1396 814. ANKYLOGLOSSIA - p. 1396 815. MAXILLARY LABIAL FRENULUM - p. 1402 816. BUCCAL FRENULA - p. 1404 817. CONTROVERSY - p. 1404 818. CONTRIBUTORS TO INCREASED FRENOTOMY RATES - p. 1405 819. CONCLUSION - p. 1405 820. 91 Pediatric Oromotor Feeding Disorders and Aversion - p. 1410 821. INTRODUCTION - p. 1410 822. EPIDEMIOLOGY - p. 1410 823. TYPICAL ORAL MOTOR/FEEDING SKILL DEVELOPMENT - p. 1411 824. CAUSES AND CLINICAL PRESENTATION OF PEDIATRIC OROMOTOR DISORDERS AND ORAL/FOOD AVERSION - p. 1411 825. ASSESSMENT AND MANAGEMENT OF OROMOTOR DISORDERS AND AVERSION - p. 1420 826. CONCLUSION - p. 1421 827. 92 Evaluation and Management of Pediatric Stridor - p. 1423 828. INTRODUCTION - p. 1423 829. PHYSIOLOGY OF STRIDOR - p. 1423 830. STRIDOR: PHASES AND LOCATION - p. 1423 831. HISTORY - p. 1425 832. PHYSICAL EXAMINATION - p. 1426 833. CASE PRESENTATIONS - p. 1428 834. CONCLUSION - p. 1431 835. ACKNOWLEDGMENTS - p. 1431 836. 93 Cough in Children - p. 1435 837. INTRODUCTION - p. 1435 838. HISTORY AND PHYSICAL EXAMINATION - p. 1435 839. DIAGNOSTIC TESTS - p. 1436 840. ENDOSCOPY - p. 1436 841. DIFFERENTIAL DIAGNOSIS - p. 1437 842. COUGH TREATMENT - p. 1439 843. CONCLUSION - p. 1440 844. 94 Pharyngeal Dysphagia and Aspiration in Children - p. 1442 845. INTRODUCTION - p. 1442 846. NORMAL AND ABNORMAL SWALLOWING PHYSIOLOGY - p. 1442 847. ETIOLOGY OF PHARYNGEAL DYSPHAGIA - p. 1443 848. EVALUATION AND MANAGEMENT OF THE CHILD WITH PHARYNGEAL DYSPHAGIA AND ASPIRATION - p. 1448 849. CONCLUSION - p. 1451 850. 95 Laryngeal Stenosis and Airway Reconstruction - p. 1455 851. INTRODUCTION - p. 1455 852. AGE-RELATED ANATOMIC DIFFERENCES IN THE LARYNX - p. 1455 853. LARYNGEAL STENOSIS - p. 1456 854. TRACHEAL STENOSIS - p. 1460 855. DIFFERENTIAL DIAGNOSIS - p. 1461 856. MANAGEMENT - p. 1461 857. DECISION-MAKING - p. 1469 858. COMPLICATIONS - p. 1470 859. EMERGENCIES - p. 1470 860. LONG-TERM MANAGEMENT - p. 1470 861. CONCLUSION - p. 1470 862. ACKNOWLEDGMENT - p. 1471 863. 96 Pediatric Voice - p. 1473 864. BACKGROUND AND EPIDEMIOLOGY - p. 1473 865. ANATOMY AND FUNCTION OF PEDIATRIC LARYNX - p. 1473 866. EVALUATION AND DIAGNOSTIC TOOLS IN PEDIATRIC VOICE - p. 1473 867. ETIOLOGIES OF PEDIATRIC DYSPHONIA - p. 1475 868. CONCLUSION - p. 1482 869. ACKNOWLEDGMENT - p. 1482 870. 97 Pediatric Tracheotomy - p. 1486 871. INTRODUCTION - p. 1486 872. INDICATIONS FOR TRACHEOTOMY - p. 1487 873. TRACHEOTOMY VERSUS ENDOTRACHEAL INTUBATION - p. 1488 874. TRACHEOTOMY TECHNIQUE - p. 1490 875. POSTOPERATIVE CARE - p. 1495 876. COMPLICATIONS OF TRACHEOTOMY - p. 1496 877. QUALITY IMPROVEMENT INITIATIVES - p. 1500 878. TRACHEOSTOMY TUBES - p. 1500 879. DECANNULATION - p. 1501 880. TRACHEOCUTANEOUS FISTULA - p. 1502 881. COMMUNICATION CONCERNS - p. 1502 882. SWALLOWING - p. 1503 883. CONCLUSION - p. 1503 884. 98 Ingestion Injuries and Foreign Bodies of the Aerodigestive Tract - p. 1507 885. INTRODUCTION - p. 1507 886. CHEMICAL HAZARDS - p. 1507 887. CLINICAL PRESENTATION - p. 1509 888. DIAGNOSIS - p. 1510 889. FOREIGN BODY INGESTION - p. 1512 890. FOREIGN BODY ASPIRATION - p. 1518 891. ACKNOWLEDGMENT - p. 1521 892. 99 Recurrent Respiratory Papillomatosis - p. 1523 893. INTRODUCTION - p. 1523 894. ETIOLOGY - p. 1524 895. EPIDEMIOLOGY - p. 1526 896. CLINICAL FEATURES - p. 1528 897. PATIENT ASSESSMENT - p. 1528 898. OTHER CONSIDERATIONS - p. 1530 899. SURGICAL MANAGEMENT - p. 1530 900. SPECIAL CONSIDERATIONS - p. 1531 901. RECURRENT RESPIRATORY PAPILLOMATOSIS STAGING - p. 1535 902. MEDICAL MANAGEMENT - p. 1538 903. ADJUVANT THERAPIES - p. 1538 904. CONCLUSION - p. 1541 905. 100 Adenotonsillar Disease in Children - p. 1545 906. INTRODUCTION - p. 1545 907. EPIDEMIOLOGY - p. 1545 908. EMBRYOLOGY - p. 1545 909. ANATOMY - p. 1546 910. IMMUNOPHYSIOLOGY - p. 1547 911. CLINICAL PRESENTATION - p. 1547 912. CLINICAL EVALUATION - p. 1549 913. MANAGEMENT - p. 1550 914. SURGICAL TECHNIQUES - p. 1552 915. OUTCOMES - p. 1553 916. CONTRAINDICATIONS - p. 1555 917. COMPLICATIONS - p. 1555 918. PERITONSILLAR ABSCESS - p. 1556 919. CONTROVERSIES - p. 1556 920. CLINICAL PRACTICE GUIDELINES - p. 1558 921. NEOPLASIA - p. 1558 922. CONCLUSION - p. 1559 923. ACKNOWLEDGMENT - p. 1559 924. 101 Diagnosis and Initial Management of Pediatric Sleep Disorders - p. 1562 925. INTRODUCTION - p. 1562 926. EPIDEMIOLOGY - p. 1562 927. PATHOPHYSIOLOGY - p. 1562 928. DIAGNOSTIC EVALUATION - p. 1563 929. TREATMENT OF OSA - p. 1567 930. MANAGING RESIDUAL OSA S/P ADENOTONSILLECTOMY - p. 1568 931. OTHER CONSIDERATIONS FOR TREATMENT OF PERSISTENT OSA - p. 1571 932. CONCLUSION - p. 1571 933. 102 Surgical Management of Pediatric Sleep Disordered Breathing - p. 1575 934. INTRODUCTION - p. 1575 935. SURGICAL TREATMENT OF OSA - p. 1576 936. PRE-, PERI-, AND POSTOPERATIVE MANAGEMENT - p. 1577 937. PERSISTENT OSA AFTER TONSILLECTOMY AND ADENOIDECTOMY - p. 1578 938. TREATMENT OF PERSISTENT OSA AFTER T&A IN CHILDREN - p. 1582 939. CONCLUSION - p. 1589 940. 103 Velopharyngeal Dysfunction - p. 1594 941. INTRODUCTION - p. 1594 942. DEFINING VELOPHARYNGEAL DYSFUNCTION - p. 1594 943. COMMON MISNOMERS - p. 1595 944. CAUSES OF VELOPHARYNGEAL INSUFFICIENCY - p. 1595 945. ASSESSMENT OF PATIENTS WITH VPD - p. 1596 946. MANAGEMENT - p. 1598 947. CONCLUSION - p. 1604 948. 104 Pediatric Rhinosinusitis: Acute and Chronic - p. 1607 949. INTRODUCTION - p. 1607 950. ANATOMY AND PATHOPHYSIOLOGY - p. 1607 951. ACUTE BACTERIAL SINUSITIS - p. 1607 952. CHRONIC RHINOSINUSITIS - p. 1609 953. COMPLICATIONS - p. 1613 954. SPECIAL POPULATIONS - p. 1615 955. ACKNOWLEDGMENTS - p. 1616 956. 105 Pediatric Allergy and Immunology - p. 1619 957. INTRODUCTION - p. 1619 958. ALLERGIC RHINITIS - p. 1619 959. FOOD ALLERGY - p. 1623 960. PEDIATRIC IMMUNOLOGY - p. 1626 961. 106 Pediatric Skull Base Lesions - p. 1631 962. INTRODUCTION - p. 1631 963. CONGENITAL PEDIATRIC SKULL BASE LESIONS - p. 1631 964. NEOPLASTIC SKULL BASE LESIONS: BENIGN - p. 1632 965. NEOPLASTIC SKULL BASE LESIONS: MALIGNANT - p. 1636 966. SKULL BASE FIBRO-OSSEOUS LESIONS - p. 1637 967. SURGICAL APPROACHES TO THE ANTERIOR PEDIATRIC SKULL BASE - p. 1640 968. SURGICAL APPROACHES TO MIDDLE CRANIAL FOSSA - p. 1640 969. SURGICAL APPROACHES TO POSTERIOR CRANIAL FOSSA - p. 1641 970. PEDIATRIC SKULL BASE RECONSTRUCTION - p. 1641 971. CONCLUSION - p. 1642 972. 107 Pediatric Salivary Gland Disorders - p. 1645 973. INTRODUCTION - p. 1645 974. INFLAMMATORY CONDITIONS - p. 1645 975. SALIVARY GLAND NEOPLASMS - p. 1647 976. EPITHELIAL NEOPLASMS - p. 1648 977. OTHER DISORDERS - p. 1652 978. ACKNOWLEDGEMENT - p. 1659 979. 108 Acute and Chronic Pediatric Otitis Media - p. 1662 980. INTRODUCTION - p. 1662 981. DEFINITIONS/SIGNS AND SYMPTOMS - p. 1662 982. EPIDEMIOLOGY - p. 1662 983. PATHOPHYSIOLOGY - p. 1663 984. RISK FACTORS - p. 1665 985. DIAGNOSIS - p. 1665 986. TREATMENT - p. 1667 987. COMPLICATIONS OF AOM AND OME - p. 1670 988. FUTURE TRENDS TO FOLLOW - p. 1670 989. ACKNOWLEDGEMENTS - p. 1671 990. 109 Newborn and Pediatric Hearing Screening and Amplification - p. 1674 991. INTRODUCTION - p. 1674 992. NEWBORN HEARING SCREENING - p. 1674 993. DIAGNOSTIC TESTING BATTERY - p. 1681 994. NONSURGICAL REHABILITATION - p. 1685 995. CONCLUSION - p. 1687 996. ACKNOWLEDGEMENT - p. 1687 997. 110 Aural Implantation and Rehabilitation in Children - p. 1690 998. INTRODUCTION - p. 1690 999. COCHLEAR IMPLANTATION IN CHILDREN - p. 1691 1000. BONE CONDUCTION IMPLANTS IN CHILDREN - p. 1705 1001. ACKNOWLEDGMENT - p. 1712 1002. 111 Genetic and Nongenetic Sources of Hearing Loss in Children - p. 1720 1003. INTRODUCTION - p. 1720 1004. OVERVIEW OF CAUSES OF HEARING LOSS IN CHILDREN - p. 1721 1005. GENETIC HEARING LOSS IN CHILDREN - p. 1721 1006. NONGENETIC HEARING LOSS IN CHILDREN - p. 1729 1007. STRUCTURAL ANOMALIES CAUSING HEARING LOSS IN CHILDREN - p. 1733 1008. DIAGNOSTIC EVALUATION FOR CHILDREN WITH HEARING LOSS - p. 1736 1009. CONCLUSION - p. 1738 1010. 112 Congenital Aural Atresia and Acquired External Auditory Canal Stenosis - p. 1741 1011. CONGENITAL MALFORMATION OF THE EAR - p. 1741 1012. ACQUIRED ATRESIA OF THE EXTERNAL AUDITORY CANAL - p. 1754 1013. CONCLUSION - p. 1756 1014. 113 Management of Cleft Lip and Palate - p. 1760 1015. INTRODUCTION - p. 1760 1016. EPIDEMIOLOGY - p. 1760 1017. EMBRYOLOGY - p. 1761 1018. PRENATAL DIAGNOSIS AND COUNSELING - p. 1762 1019. FEEDING - p. 1763 1020. CLEFT LIP REPAIR - p. 1763 1021. CLEFT PALATE REPAIR - p. 1769 1022. CONCLUSION - p. 1776 1023. 114 Vascular Anomalies of the Head and Neck - p. 1779 1024. INTRODUCTION - p. 1779 1025. VASCULAR TUMORS - p. 1779 1026. VASCULAR MALFORMATIONS - p. 1788 1027. GENETICS OF VASCULAR ANOMALIES - p. 1794 1028. 115 Pediatric Head and Neck Tumors - p. 1797 1029. INTRODUCTION - p. 1797 1030. DIAGNOSTIC APPROACH - p. 1797 1031. RHABDOMYOSARCOMAS - p. 1798 1032. NONRHABDOMYOSARCOMA SOFT TISSUE SARCOMAS - p. 1801 1033. EWING SARCOMA FAMILY OF TUMORS - p. 1803 1034. MAXILLARY AND MANDIBULAR TUMORS - p. 1804 1035. SALIVARY GLAND MALIGNANCY - p. 1806 1036. NASOPHARYNGEAL CARCINOMA - p. 1808 1037. MELANOMA - p. 1809 1038. CONCLUSION - p. 1810 1039. 116 Pediatric Thyroid Disease - p. 1814 1040. INTRODUCTION - p. 1814 1041. ANATOMY AND EMBRYOLOGY - p. 1814 1042. BENIGN PEDIATRIC THYROID DISEASE - p. 1815 1043. PEDIATRIC THYROID MALIGNANCIES - p. 1817 1044. PEDIATRIC THYROID NODULE EVALUATION - p. 1819 1045. THYROID SURGERY - p. 1820 1046. POSTOPERATIVE THYROID CANCER CONSIDERATIONS - p. 1825 1047. CONCLUSION - p. 1827 1048. 117 Congenital Cysts, Sinuses, and Infections of the Head and Neck - p. 1830 1049. INTRODUCTION - p. 1830 1050. BRANCHIAL APPARATUS ANOMALIES - p. 1830 1051. PREAURICULAR CYSTS AND SINUSES - p. 1834 1052. THYROGLOSSAL DUCT ANOMALIES - p. 1835 1053. DERMOID CYSTS - p. 1837 1054. ACKNOWLEDGMENT - p. 1838 1055. 118 Relevant Syndromes in Pediatric Otolaryngology - p. 1840 1056. INTRODUCTION - p. 1840 1057. GENETICS OVERVIEW - p. 1840 1058. A PRACTICAL APPROACH TO THE INFANT OR CHILD WHO IS SYNDROMIC - p. 1844 1059. APERT SYNDROME - p. 1844 1060. BRANCHIOOTORENAL SYNDROME - p. 1846 1061. CHARGE ASSOCIATION - p. 1847 1062. CROUZON SYNDROME - p. 1849 1063. DOWN SYNDROME - p. 1849 1064. GOLDENHAR SYNDROME - p. 1850 1065. KARTAGENER SYNDROME - p. 1852 1066. MELKERSSON-ROSENTHAL SYNDROME - p. 1853 1067. NEUROFIBROMATOSIS 1 - p. 1853 1068. NEUROFIBROMATOSIS 2 - p. 1853 1069. PIERRE ROBIN SEQUENCE - p. 1854 1070. VELOCARDIOFACIAL SYNDROME/DIGEORGE SYNDROME/SHPRINTZEN SYNDROME - p. 1855 1071. TREACHER COLLINS SYNDROME - p. 1856 1072. USHER SYNDROME - p. 1857 1073. WAARDENBURG SYNDROME - p. 1857 1074. PENDRED SYNDROME - p. 1858 1075. FETAL ALCOHOL SYNDROME - p. 1858 1076. MANIFESTATIONS OF OTHER SYNDROMES AND CONDITIONS - p. 1859 1077. ACKNOWLEDGMENT - p. 1865 1078. 119 Anesthesia Considerations for Pediatric Otolaryngology - p. 1869 1079. INTRODUCTION - p. 1869 1080. PREOPERATIVE CONSIDERATIONS - p. 1869 1081. INTRAOPERATIVE MANAGEMENT - p. 1879 1082. POSTOPERATIVE CONSIDERATIONS - p. 1883 1083. ANESTHETIC CONSIDERATIONS FOR SPECIFIC OTORHINOLARYNGOLOGIC PROCEDURES - p. 1885 1084. CONCLUSION - p. 1889 1085. 120 Pediatric Facial Trauma - p. 1894 1086. EPIDEMIOLOGY - p. 1894 1087. SPECIAL CONSIDERATIONS IN PEDIATRIC FACIAL TRAUMA - p. 1894 1088. SOFT TISSUE INJURIES - p. 1895 1089. NASAL FRACTURES - p. 1896 1090. MANDIBLE FRACTURES - p. 1898 1091. MIDFACE FRACTURES - p. 1900 1092. ORBITAL AND FRONTAL SINUS FRACTURES - p. 1901 1093. NASOORBITOETHMOID FRACTURES - p. 1903 1094. FRACTURE FIXATION AND PLATING SYSTEMS - p. 1904 1095. CONCLUSION - p. 1905 1096. 121 Infections of the Pediatric Upper and Lower Airway - p. 1908 1097. INTRODUCTION - p. 1908 1098. NASAL SEPTAL ABSCESS - p. 1908 1099. PEDIATRIC RHINOSINUSITIS - p. 1910 1100. DEEP NECK SPACE INFECTIONS - p. 1912 1101. PARAPHARYNGEAL AND RETROPHARYNGEAL ABSCESS - p. 1914 1102. MEDIASTINITIS AND THROMBOPHLEBITIS - p. 1915 1103. ADENOTONSILLAR INFECTIONS - p. 1916 1104. TONSILLITIS - p. 1917 1105. PERITONSILLAR ABSCESS - p. 1918 1106. EPIGLOTTITIS - p. 1918 1107. CROUP (LARYNGOTRACHEITIS) - p. 1919 1108. BRONCHIOLITIS - p. 1920 1109. PNEUMONIA - p. 1920 1110. 122 Surgical Management of Craniofacial Disorders - p. 1925 1111. INTRODUCTION - p. 1925 1112. ANATOMY AND DEVELOPMENT OF THE CRANIOFACIAL SKELETON - p. 1925 1113. SYNDROMES ASSOCIATED WITH CRANIOFACIAL DISORDERS - p. 1926 1114. MANDIBULAR HYPOPLASIA - p. 1928 1115. CRANIOSYNOSTOSIS - p. 1930 1116. MAXILLARY DISTRACTION - p. 1934 1117. MIDFACE SURGERY - p. 1934 1118. CONCLUSION - p. 1936 1119. 123 Management of Reflux and Eosinophilic Esophagitis - p. 1938 1120. INTRODUCTION - p. 1938 1121. GASTROESOPHAGEAL REFLUX AND GASTROESOPHAGEAL REFLUX DISEASE - p. 1938 1122. EOSINOPHILIC ESOPHAGITIS - p. 1941 1123. CONCLUSION - p. 1945 1124. VOLUME TWO - p. 1949 1125. SECTION VII: HEAD AND NECK SURGERY - p. 1949 1126. 124 Head and Neck Tumor Biology - p. 1951 1127. INTRODUCTION - p. 1951 1128. DIFFERENT SUBTYPES OF HNSCC IDENTIFIED BASED ON RISK FACTORS AND GENETICS - p. 1951 1129. PATHOGENESIS AND FIELD CANCERIZATION - p. 1953 1130. Upstream of the Cell Cycle: Epidermal Growth Factor Receptor and Tgfβ - p. 1955 1131. CELL CYCLE REGULATION - p. 1958 1132. CELL CYCLE REGULATORS: A CHECK ON PROLIFERATION - p. 1961 1133. DNA REPAIR PATHWAYS MAINTAIN GENOME INTEGRITY - p. 1963 1134. APOPTOSIS IS DISRUPTED IN CANCER - p. 1967 1135. CANCER STEM CELLS CONTRIBUTE TO TUMOR HETEROGENEITY - p. 1969 1136. TUMOR MICROENVIRONMENT MODULATES TUMOR GROWTH - p. 1970 1137. ANGIOGENESIS AND VASCULOGENESIS FEED TUMOR GROWTH - p. 1971 1138. IMMUNE RESPONSE IMPACTS TUMOR GROWTH - p. 1972 1139. CONCLUSION - p. 1973 1140. 125 Tumor Immunology and Immunotherapy - p. 1980 1141. BASIC PRINCIPLES OF TUMOR IMMUNOLOGY - p. 1980 1142. IMMUNE ESCAPE IN HEAD AND NECK CANCER - p. 1982 1143. IMMUNOTHERAPEUTIC STRATEGIES FOR TREATMENT OF HEAD AND NECK CANCER - p. 1984 1144. 126 Principles of Multidisciplinary Treatment in Head and Neck Cancer - p. 1995 1145. DEFINITION OF MULTIDISCIPLINARY CARE - p. 1995 1146. OVERALL IMPACT OF MULTIDISCIPLINARY TEAMS - p. 1996 1147. CENTRALIZATION OF SERVICES, CARE PATHWAYS, AND QUALITY INDICATORS - p. 1996 1148. MULTIDISCIPLINARY CARE AND QUALITY OF LIFE METRICS - p. 1997 1149. SURVIVAL IMPACT OF MULTIDISCIPLINARY TEAMS - p. 1998 1150. PATTERNS OF MULTIDISCIPLINARY CARE - p. 1998 1151. TELEMEDICINE AND VIRTUAL MULTIDISCIPLINARY CARE - p. 1998 1152. 127 Principles of Head and Neck Radiation Oncology - p. 2001 1153. RADIATION BIOLOGY - p. 2001 1154. RADIATION DOSE MEASUREMENTS AND RADIATION SAFETY - p. 2002 1155. RADIATION DOSE AND FRACTIONATION - p. 2003 1156. 128 Chemotherapy and Targeted Therapy in Head and Neck Cancer - p. 2014 1157. INTRODUCTION - p. 2014 1158. HNSCC BIOLOGY AND SENSITIVITY/RESISTANCE TO SYSTEMIC THERAPY - p. 2015 1159. SYSTEMIC THERAPY IN HEAD AND NECK SQUAMOUS CELL CARCINOMA - p. 2017 1160. CHEMOTHERAPY DRUGS USED TO TREAT HEAD AND NECK CANCER - p. 2023 1161. TARGETED THERAPY - p. 2024 1162. CLINICAL TRIALS - p. 2024 1163. 129 Salvage Surgery in Head and Neck Cancer - p. 2029 1164. INTRODUCTION - p. 2029 1165. EFFECTS OF RADIATION (AND CHEMOTHERAPY) ON TISSUE - p. 2029 1166. CONSIDERATIONS PRIOR TO SALVAGE SURGERY - p. 2030 1167. RECONSTRUCTIVE SURGERY IN THE HEAD NECK - p. 2031 1168. SALVAGE SURGERY BY ANATOMIC SITE - p. 2031 1169. NASOPHARYNX - p. 2033 1170. ORAL CAVITY - p. 2034 1171. OROPHARYNX - p. 2035 1172. LARYNGEAL CANCER - p. 2037 1173. SALVAGE SURGERY IN MAJOR SALIVARY GLANDS - p. 2038 1174. SURGERY FOR RECURRENT CUTANEOUS MALIGNANCY - p. 2040 1175. SALVAGE NECK DISSECTION AND CAROTID MANAGEMENT - p. 2040 1176. 130 Nonmelanoma Skin Cancer - p. 2044 1177. OVERVIEW AND EPIDEMIOLOGY - p. 2044 1178. RISK FACTORS - p. 2044 1179. WORKUP OF NONMELANOMA SKIN CANCERS - p. 2045 1180. BASAL CELL CARCINOMA - p. 2045 1181. CUTANEOUS SQUAMOUS CELL CARCINOMA - p. 2050 1182. MERKEL CELL CARCINOMA - p. 2054 1183. FOLLOW-UP AND PREVENTION - p. 2055 1184. 131 Malignant Melanoma of the Head and Neck Region - p. 2058 1185. INTRODUCTION - p. 2058 1186. EPIDEMIOLOGY - p. 2058 1187. CLINICAL PRESENTATION AND DIAGNOSIS - p. 2058 1188. PATHOLOGY - p. 2059 1189. MELANOMA SUBTYPES - p. 2059 1190. MUCOSAL MELANOMA - p. 2061 1191. MELANOMA STAGING SYSTEM - p. 2062 1192. TREATMENT - p. 2064 1193. NODAL EVALUATION - p. 2065 1194. SYSTEMIC THERAPY - p. 2070 1195. SURVEILLANCE - p. 2073 1196. CONCLUSION - p. 2073 1197. 132 Salivary Gland Neoplasms - p. 2079 1198. EPIDEMIOLOGY - p. 2079 1199. ANATOMY, ETIOLOGY, AND PATHOPHYSIOLOGY - p. 2079 1200. EVALUATION - p. 2080 1201. INVESTIGATIONS - p. 2080 1202. BENIGN SALIVARY NEOPLASMS - p. 2082 1203. MALIGNANT SALIVARY NEOPLASMS - p. 2084 1204. TREATMENT - p. 2086 1205. ADJUVANT TREATMENTS - p. 2089 1206. COMPLICATIONS OF TREATMENT - p. 2089 1207. 133 Lip Cancer and Reconstruction - p. 2092 1208. FUNCTIONAL ANATOMY - p. 2092 1209. BIOLOGICAL BEHAVIOR - p. 2093 1210. CLINICAL EVALUATION - p. 2095 1211. MANAGEMENT - p. 2095 1212. LIP RECONSTRUCTION - p. 2097 1213. NEAR-TOTAL TO TOTAL CIRCUMFERENTIAL DEFECTS OF THE LIP - p. 2108 1214. COMPLICATIONS - p. 2109 1215. EMERGENCIES - p. 2109 1216. 134 Neck Dissection: Anatomy, Workup, and Indications for Oncologic Treatment - p. 2113 1217. ANATOMY - p. 2113 1218. DIAGNOSTIC EVALUATION - p. 2117 1219. STAGING - p. 2121 1220. CLASSIFICATION OF DIFFERENT NECK DISSECTIONS - p. 2122 1221. CURRENT CONTROVERSIES - p. 2126 1222. CONTRAINDICATIONS - p. 2127 1223. COMPLICATIONS - p. 2127 1224. CONTRAINDICATIONS - p. 2129 1225. 135 Nasopharyngeal Carcinoma - p. 2133 1226. INTRODUCTION - p. 2133 1227. HISTOPATHOLOGY - p. 2134 1228. CLINICAL PRESENTATIONS - p. 2134 1229. SCREENING - p. 2136 1230. DIAGNOSIS - p. 2136 1231. SEROLOGY AND LIQUID BIOPSY - p. 2136 1232. ENDOSCOPIC EXAMINATION - p. 2137 1233. IMAGING STUDIES - p. 2137 1234. STAGING - p. 2141 1235. TREATMENT - p. 2142 1236. MANAGEMENT OF PERSISTENT, RECURRENT OR METASTATIC DISEASE - p. 2143 1237. COMPLICATIONS OF PRIMARY NPC TREATMENT - p. 2149 1238. 136 Oral Cavity Cancer - p. 2155 1239. ANATOMY - p. 2155 1240. EPIDEMIOLOGY - p. 2159 1241. ETIOLOGY - p. 2159 1242. PRESENTATION - p. 2160 1243. DIAGNOSIS AND EVALUATION - p. 2161 1244. STAGING AND PROGNOSIS - p. 2165 1245. TREATMENT - p. 2166 1246. COMPLICATIONS - p. 2173 1247. FUTURE DIRECTIONS - p. 2174 1248. 137 Oropharyngeal Cancer - p. 2181 1249. INTRODUCTION - p. 2181 1250. ANATOMY - p. 2181 1251. PHYSIOLOGY - p. 2183 1252. ETIOLOGY - p. 2183 1253. HISTOPATHOLOGY - p. 2184 1254. NATURAL HISTORY - p. 2185 1255. DIAGNOSIS - p. 2187 1256. TREATMENT PLANNING - p. 2189 1257. RECONSTRUCTION - p. 2192 1258. EMERGENCIES - p. 2192 1259. FOLLOW-UP - p. 2192 1260. PROGNOSIS - p. 2192 1261. NEW AND DEVELOPING TREATMENTS - p. 2193 1262. 138 Unknown Primary Cancer of the Head and Neck - p. 2197 1263. INTRODUCTION - p. 2197 1264. EPIDEMIOLOGY - p. 2197 1265. HISTOPATHOLOGY - p. 2197 1266. PUTATIVE OCCULT PRIMARY SITES IN THE HEAD AND NECK - p. 2198 1267. STAGING - p. 2199 1268. WORKUP - p. 2199 1269. CONCLUSION - p. 2206 1270. 139 Robotics in Head and Neck Surgery - p. 2210 1271. INTRODUCTION - p. 2210 1272. CURRENT ROBOTIC SYSTEMS - p. 2210 1273. PATIENT SELECTION FOR TORS (Fig. 139.2) - p. 2211 1274. AIRWAY MANAGEMENT - p. 2213 1275. EXPOSURE - p. 2216 1276. OROPHARYNGEAL CANCER - p. 2216 1277. CANCER OF UNKNOWN PRIMARY - p. 2220 1278. LARYNGEAL CANCER - p. 2221 1279. NASOPHARYNX AND ANTERIOR CRANIAL BASE - p. 2221 1280. PARAPHARYNGEAL SPACE - p. 2222 1281. THYROID - p. 2222 1282. PARATHYROID - p. 2223 1283. CERVICAL LYMPH NODE DISSECTION - p. 2223 1284. RECONSTRUCTION - p. 2223 1285. CONTROVERSIES IN ROBOTIC SURGERY - p. 2223 1286. CONCLUSIONS - p. 2225 1287. 140 Hypopharyngeal and Cervical Esophageal Carcinoma - p. 2228 1288. INTRODUCTION - p. 2228 1289. ANATOMY - p. 2228 1290. EPIDEMIOLOGY - p. 2229 1291. ETIOLOGY - p. 2230 1292. DIAGNOSIS - p. 2230 1293. PATHOLOGY - p. 2233 1294. PROGNOSIS - p. 2234 1295. MANAGEMENT - p. 2235 1296. MANAGEMENT OF THE NECK - p. 2243 1297. RECONSTRUCTION - p. 2243 1298. NONSURGICAL THERAPIES FOR HYPOPHARYNGEAL AND CERVICAL ESOPHAGEAL CARCINOMA - p. 2244 1299. SALVAGE SURGERY - p. 2246 1300. FUNCTIONAL OUTCOMES - p. 2247 1301. COMPLICATIONS - p. 2247 1302. 141 Early Laryngeal Cancer - p. 2252 1303. EPIDEMIOLOGY - p. 2252 1304. RISK FACTORS - p. 2252 1305. TUMOR BIOLOGY - p. 2252 1306. ANATOMY OF THE LARYNX - p. 2253 1307. PREINVASIVE LESIONS - p. 2254 1308. EARLY SUPRAGLOTTIC CANCER - p. 2255 1309. SURGERY - p. 2257 1310. SURGICAL OUTCOMES - p. 2263 1311. RADIOTHERAPY - p. 2263 1312. EARLY GLOTTIC CANCER - p. 2264 1313. RADIOTHERAPY - p. 2273 1314. EARLY SUBGLOTTIC CANCER - p. 2275 1315. TREATMENT - p. 2275 1316. SUMMARY - p. 2276 1317. ACKNOWLEDGMENTS - p. 2276 1318. 142 Advanced Laryngeal Cancer - p. 2282 1319. INTRODUCTION - p. 2282 1320. EPIDEMIOLOGY - p. 2282 1321. ETIOLOGY - p. 2282 1322. PATHOLOGY - p. 2282 1323. ANATOMY - p. 2283 1324. PATTERNS OF SPREAD - p. 2283 1325. CLINICAL ASSESSMENT - p. 2284 1326. INVESTIGATION - p. 2284 1327. STAGING - p. 2286 1328. TREATMENT - p. 2287 1329. OUTCOMES - p. 2293 1330. 143 Tracheal Tumors - p. 2298 1331. INTRODUCTION - p. 2298 1332. CLINICAL PRESENTATION AND EVALUATION - p. 2298 1333. PATHOLOGY - p. 2300 1334. INITIAL AIRWAY MANAGEMENT - p. 2301 1335. DEFINITIVE SURGICAL MANAGEMENT - p. 2301 1336. ENDOSCOPIC AND NONOPERATIVE MANAGEMENT - p. 2306 1337. 144 Soft Tissue Tumors of the Head and Neck - p. 2310 1338. INTRODUCTION - p. 2310 1339. HEAD AND NECK PARAGANGLIOMAS - p. 2310 1340. SCHWANNOMAS OF THE HEAD AND NECK - p. 2316 1341. SOFT TISSUE SARCOMAS OF THE HEAD AND NECK - p. 2319 1342. 145 Lymphomas of the Head and Neck - p. 2327 1343. INTRODUCTION - p. 2327 1344. EPIDEMIOLOGY - p. 2327 1345. CLINICAL DIAGNOSIS AND IMAGING - p. 2328 1346. TISSUE DIAGNOSIS - p. 2330 1347. STAGING - p. 2330 1348. THERAPY - p. 2331 1349. LYMPHOMA SPECIFIC TO THE HEAD AND NECK - p. 2333 1350. CONCLUSION - p. 2337 1351. 146 Neoplasms of the Nose and Paranasal Sinuses - p. 2342 1352. BACKGROUND - p. 2342 1353. EVALUATION AND WORK-UP - p. 2342 1354. PATHOLOGY, TREATMENT, AND PROGNOSIS - p. 2344 1355. BENIGN TUMORS - p. 2344 1356. BENIGN PATHOLOGIES - p. 2345 1357. WHO CLASSIFICATION OF TUMORS - p. 2346 1358. CARCINOMAS - p. 2346 1359. SURGERY - p. 2352 1360. CONCLUSION - p. 2353 1361. 147 Orbital Tumors - p. 2357 1362. INTRODUCTION - p. 2357 1363. VASCULAR TUMORS - p. 2360 1364. HEMATOPOIETIC TUMORS - p. 2361 1365. NEURAL TUMORS - p. 2363 1366. INFLAMMATORY TUMORS - p. 2364 1367. CYSTS - p. 2365 1368. MESENCHYMAL TUMORS - p. 2366 1369. LACRIMAL TUMORS - p. 2368 1370. SECONDARY LESIONS - p. 2368 1371. METASTATIC TUMORS - p. 2369 1372. SURGICAL APPROACHES - p. 2369 1373. GENERAL OPERATIVE PRINCIPLES AND POSTOPERATIVE CARE - p. 2371 1374. INFERIOR APPROACH (INFERIOR FORNIX, TRANSCONJUNCTIVAL) - p. 2373 1375. LATERAL APPROACH (LATERAL RETROCANTHAL + OPTIONAL CANTHOTOMY–CANTHOLYSIS) - p. 2374 1376. CONCLUSION - p. 2374 1377. 148 Cranial Base Surgery - p. 2377 1378. INTRODUCTION - p. 2377 1379. HISTORY - p. 2377 1380. ANATOMY - p. 2378 1381. CLINICAL DIFFERENTIAL DIAGNOSIS - p. 2381 1382. IMAGING IN CRANIAL BASE SURGERY - p. 2382 1383. OPERATIVE MANAGEMENT - p. 2382 1384. COMPLICATIONS - p. 2390 1385. CONCLUSION - p. 2391 1386. 149 Odontogenic Cysts, Tumors, and Related Jaw Lesions - p. 2394 1387. INTRODUCTION - p. 2394 1388. ODONTOGENIC CYSTS - p. 2394 1389. INFLAMMATORY CYSTS - p. 2394 1390. DEVELOPMENTAL CYSTS - p. 2395 1391. NONODONTOGENIC CYSTS - p. 2398 1392. ODONTOGENIC TUMORS - p. 2398 1393. RELATED JAW LESIONS - p. 2405 1394. CONCLUSION - p. 2411 1395. 150 Thyroid Neoplasms - p. 2414 1396. INTRODUCTION - p. 2414 1397. HISTOLOGY OF THE NORMAL THYROID GLAND - p. 2414 1398. 151 Hyperparathyroidism: Evaluation and Surgical Management - p. 2423 1399. INTRODUCTION - p. 2423 1400. EMBRYOLOGY AND ANATOMICAL CONSIDERATIONS - p. 2423 1401. CALCIUM HOMEOSTASIS - p. 2423 1402. PARATHYROID GLAND HISTOLOGY - p. 2424 1403. HYPERPARATHYROIDISM - p. 2424 1404. CLINICAL MANIFESTATIONS - p. 2425 1405. EVALUATION - p. 2425 1406. INDICATIONS FOR SURGERY - p. 2428 1407. PARATHYROIDECTOMY - p. 2429 1408. MEDIASTINAL ADENOMA - p. 2434 1409. PARATHYROID CARCINOMA - p. 2435 1410. POSTOPERATIVE CARE - p. 2435 1411. 152 Surveillance and Survivorship in Head and Neck Cancer - p. 2440 1412. INTRODUCTION—WHY SURVIVORSHIP? - p. 2440 1413. CURRENT SURVIVORSHIP MODELS - p. 2440 1414. SURVEILLANCE - p. 2440 1415. PATIENT-REPORTED OUTCOME MEASURES - p. 2441 1416. CHOOSING A CLINICAL MODEL - p. 2442 1417. SPECIFIC LLE - p. 2444 1418. QOL IN HNC SURVIVORS - p. 2445 1419. FINANCIAL TOXICITY - p. 2446 1420. REHABILITATION - p. 2446 1421. NEXT STEPS - p. 2446 1422. CONCLUSION - p. 2447 1423. 153 Swallowing Therapy in Head and Neck Cancers and Late Effects of Therapy in Head and Neck Cancers - p. 2451 1424. INTRODUCTION - p. 2451 1425. DYSPHAGIA AFTER HEAD AND NECK SURGERY - p. 2452 1426. RADIATION THERAPY - p. 2454 1427. TREATMENT OF DYSPHAGIA IN HEAD AND NECK CANCERS - p. 2456 1428. MANAGEMENT OF END-STAGE DYSPHAGIA - p. 2460 1429. MULTIDISCIPLINARY TEAM - p. 2461 1430. CONCLUSION - p. 2461 1431. 154 Voice Restoration after Total Laryngectomy - p. 2464 1432. INTRODUCTION - p. 2464 1433. SHUNTS AND VALVES - p. 2465 1434. PRIMARY VERSUS SECONDARY TE PUNCTURE - p. 2466 1435. PATIENT SELECTION AND TIMING - p. 2466 1436. SURGICAL PROCEDURE—SECONDARY TE PUNCTURE - p. 2467 1437. SURGICAL PROCEDURE—PRIMARY TE PUNCTURE - p. 2468 1438. TREATMENT OF PHARYNGEAL CONSTRICTOR SPASM - p. 2469 1439. COMPLICATIONS - p. 2471 1440. POSTOPERATIVE REHABILITATION - p. 2471 1441. PREDICTORS OF SUCCESSFUL TRACHEOESOPHAGEAL SPEECH - p. 2472 1442. VOICE QUALITY - p. 2473 1443. EMERGENCIES - p. 2473 1444. SECTION VIII: SLEEP MEDICINE AND SURGERY - p. 2477 1445. 155 Sleep Medicine for the Otolaryngologist - p. 2479 1446. INTRODUCTION - p. 2479 1447. OVERVIEW OF NORMAL SLEEP - p. 2479 1448. OVERVIEW OF SLEEP DISORDERS—THE SLEEPY PATIENT - p. 2479 1449. EVALUATION OF THE PATIENT WITH A SLEEP DISORDER - p. 2484 1450. RADIOLOGIC EVALUATION OF THE AIRWAY IN SLEEP-DISORDERED BREATHING - p. 2497 1451. DIAGNOSIS OF SLEEP DISORDERS - p. 2498 1452. TREATMENT OF SLEEP DISORDERS - p. 2501 1453. 156 Medical Therapy for Obstructive Sleep Apnea - p. 2505 1454. INTRODUCTION - p. 2505 1455. POSITIVE AIRWAY PRESSURE - p. 2505 1456. ORAL APPLIANCE THERAPY FOR OSA - p. 2512 1457. RESULTS - p. 2515 1458. WEIGHT LOSS - p. 2516 1459. OTHER ADJUNCTIVE THERAPY - p. 2517 1460. TREATMENT OF ASSOCIATED CONDITIONS - p. 2520 1461. 157 Obstructive Sleep Apnea: Pathophysiology, Drug-Induced Sleep Endoscopy, and Endotyping - p. 2525 1462. INTRODUCTION - p. 2525 1463. ANATOMIC CONTRIBUTIONS TO OSA PATHOPHYSIOLOGY - p. 2525 1464. NONANATOMIC CONTRIBUTIONS TO OSA PATHOPHYSIOLOGY - p. 2530 1465. CONCLUSION - p. 2532 1466. 158 Nonapneic Snoring and Upper Airway Resistance Syndrome - p. 2536 1467. INTRODUCTION - p. 2536 1468. BACKGROUND INFORMATION - p. 2536 1469. SNORING TREATMENT - p. 2537 1470. 159 Nasal Surgery for Sleep-disordered Breathing - p. 2542 1471. NASAL AIRWAY ANATOMY - p. 2542 1472. NASAL OBSTRUCTION - p. 2542 1473. CONCLUSION - p. 2549 1474. 160 Pharyngeal Surgery - p. 2551 1475. INTRODUCTION - p. 2551 1476. DIAGNOSIS AND EVALUATION - p. 2552 1477. ROLE OF DISE IN SURGICAL PLANNING - p. 2554 1478. PALATE SURGERY - p. 2554 1479. LOWER PHARYNGEAL SURGERY - p. 2560 1480. FUTURE DIRECTIONS - p. 2564 1481. 161 Neurostimulation - p. 2568 1482. INTRODUCTION - p. 2568 1483. SELECTION CRITERIA - p. 2568 1484. SURGICAL TECHNIQUE - p. 2570 1485. IMMEDIATE FOLLOW-UP AND PROGRAMMING - p. 2573 1486. ADVERSE EVENTS AND MANAGEMENT - p. 2575 1487. SPECIAL SURGICAL CIRCUMSTANCES - p. 2578 1488. DEVELOPMENT AND EFFICACY - p. 2580 1489. MULTIDISCIPLINARY APPROACH - p. 2581 1490. OTHER NEUROSTIMULATION DEVICES FOR TREATMENT OF SLEEP APNEA - p. 2581 1491. FUTURE DIRECTIONS - p. 2582 1492. 162 Skeletal Surgery - p. 2584 1493. INTRODUCTION - p. 2584 1494. MAXILLOMANDIBULAR ADVANCEMENT - p. 2584 1495. GENIOGLOSSUS ADVANCEMENT - p. 2588 1496. RAPID MAXILLARY EXPANSION - p. 2591 1497. CONCLUSION - p. 2595 1498. SECTION IX: OTOLOGY AND NEUROTOLOGY - p. 2599 1499. 163 Development of the Ear - p. 2601 1500. AURICULAR DEVELOPMENT - p. 2601 1501. DEVELOPMENTAL ANOMALIES - p. 2602 1502. DEVELOPMENT OF THE EXTERNAL AND MIDDLE EAR - p. 2603 1503. DEVELOPMENT OF THE FACIAL NERVE - p. 2606 1504. DEVELOPMENT OF THE INNER EAR - p. 2606 1505. DEVELOPMENT OF INNERVATION OF THE MEMBRANOUS LABYRINTH - p. 2609 1506. DEVELOPMENT OF THE OSSEOUS LABYRINTH - p. 2609 1507. DEVELOPMENT OF THE OTIC CAPSULE - p. 2609 1508. CONTROL OF EAR DEVELOPMENT - p. 2612 1509. 164 Anatomy and Physiology of Hearing - p. 2616 1510. INTRODUCTION - p. 2616 1511. EXTERNAL EAR - p. 2616 1512. TYMPANIC MEMBRANE - p. 2619 1513. MIDDLE EAR - p. 2620 1514. COCHLEA - p. 2624 1515. ORGAN OF CORTI - p. 2627 1516. SUMMARY OF TRANSDUCTION - p. 2631 1517. COCHLEAR NUCLEUS - p. 2632 1518. SUPERIOR OLIVARY COMPLEX - p. 2633 1519. LATERAL LEMNISCUS - p. 2633 1520. INFERIOR COLLICULUS - p. 2633 1521. MEDIAL GENICULATE BODY OF THE THALAMUS - p. 2633 1522. AUDITORY CORTEX - p. 2634 1523. THE EFFERENT AUDITORY PATHWAY - p. 2634 1524. BRAINSTEM AUDITORY EVOKED POTENTIALS - p. 2635 1525. IN SUMMARY - p. 2636 1526. ACKNOWLEDGMENTS - p. 2636 1527. 165 Assessment of Peripheral and Central Auditory Function - p. 2639 1528. INTRODUCTION - p. 2639 1529. BASIC AUDIOLOGIC TEST BATTERY - p. 2639 1530. OTOACOUSTIC EMISSIONS - p. 2644 1531. GUIDELINES FOR EVALUATION OF HEARING HANDICAP - p. 2657 1532. AUDITORY EVOKED RESPONSES - p. 2658 1533. ASSESSMENT OF AUDITORY PROCESSING DISORDERS - p. 2663 1534. STAFF TRAINING AND AUTOMATED TESTING - p. 2664 1535. GLOSSARY - p. 2665 1536. 166 Vestibular Function and Anatomy - p. 2669 1537. GROSS ANATOMY OF THE VESTIBULAR SYSTEM - p. 2669 1538. CELLULAR ANATOMY OF THE VESTIBULAR END ORGANS - p. 2674 1539. PHYSICS OF MECHANOTRANSDUCTION - p. 2676 1540. VESTIBULAR BRAINSTEM - p. 2678 1541. VESTIBULAR TESTING - p. 2679 1542. CURRENT AREAS OF RESEARCH - p. 2679 1543. 167 Assessment of Vestibular and Balance Function Using Laboratory Testing - p. 2681 1544. INTRODUCTION - p. 2681 1545. LABORATORY ASSESSMENT OF THE OCULAR MOTOR SYSTEM - p. 2682 1546. LABORATORY ASSESSMENT OF THE SEMICIRCULAR CANALS - p. 2685 1547. LABORATORY ASSESSMENT OF THE OTOLITH ORGANS - p. 2691 1548. THE USE OF VESTIBULAR STUDIES FOR LOCALIZATION OF IMPAIRMENT IN COMMON OTOLOGIC DISORDERS - p. 2697 1549. 168 Neurophysiologic Intraoperative Monitoring - p. 2704 1550. INTRODUCTION - p. 2704 1551. AUDITORY SYSTEM MONITORING - p. 2704 1552. INTRAOPERATIVE FACIAL NERVE MONITORING - p. 2713 1553. MONITORING OTHER CRANIAL NERVES - p. 2719 1554. CONCLUSION - p. 2719 1555. 169 Diseases of the External Ear - p. 2724 1556. EMBRYOLOGY - p. 2724 1557. ANATOMY AND PHYSIOLOGY - p. 2724 1558. INFECTIONS OF THE EXTERNAL EAR - p. 2726 1559. NONINFECTIOUS DISORDERS OF THE EXTERNAL EAR - p. 2738 1560. 170 Eustachian Tube Dysfunction - p. 2751 1561. INTRODUCTION - p. 2751 1562. ANATOMY AND PHYSIOLOGY OF THE EUSTACHIAN TUBE - p. 2751 1563. DIAGNOSIS AND EVALUATION OF EUSTACHIAN TUBE DYSFUNCTION - p. 2752 1564. DIFFERENTIAL DIAGNOSIS FOR AURAL FULLNESS - p. 2755 1565. OBSTRUCTIVE EUSTACHIAN TUBE DYSFUNCTION - p. 2757 1566. PATULOUS EUSTACHIAN TUBE DYSFUNCTION - p. 2762 1567. CONCLUSION - p. 2765 1568. 171 Intratemporal and Intracranial Complications of Otitis Media - p. 2770 1569. INTRODUCTION - p. 2770 1570. PATHOPHYSIOLOGY - p. 2770 1571. GENERAL PATTERNS OF PRESENTATION - p. 2772 1572. INTRATEMPORAL (EXTRACRANIAL) COMPLICATIONS - p. 2773 1573. INTRACRANIAL COMPLICATIONS - p. 2777 1574. 172 Middle Ear and Temporal Bone Trauma - p. 2783 1575. INTRODUCTION - p. 2783 1576. EPIDEMIOLOGY - p. 2783 1577. PATHOPHYSIOLOGY - p. 2783 1578. CLASSIFICATION - p. 2783 1579. MANAGEMENT - p. 2787 1580. 173 Cholesteatoma—Pathogenesis and Treatment - p. 2801 1581. INTRODUCTION - p. 2801 1582. CONGENITAL CHOLESTEATOMA - p. 2801 1583. ACQUIRED CHOLESTEATOMA - p. 2802 1584. SURGICAL ANATOMY - p. 2804 1585. PREVENTION - p. 2806 1586. PREOPERATIVE EVALUATION - p. 2808 1587. SURGICAL MANAGEMENT - p. 2809 1588. COMPLICATIONS AND EMERGENCIES - p. 2811 1589. 174 Surgery of the Mastoid and Petrosa - p. 2819 1590. HISTORY - p. 2819 1591. INDICATIONS FOR MASTOIDECTOMY - p. 2819 1592. SURGICAL TECHNIQUE: MASTOIDECTOMY - p. 2819 1593. MANAGING THE CANAL-WALL-DOWN CAVITY - p. 2828 1594. MASTOIDECTOMY FOR ENDOLYMPHATIC HYDROPS - p. 2829 1595. MASTOIDECTOMY FOR SEMICIRCULAR CANAL OCCLUSION - p. 2830 1596. MASTOIDECTOMY FOR CEREBROSPINAL FLUID LEAK - p. 2830 1597. PETROUS APICECTOMY - p. 2831 1598. COMPLICATIONS AND EMERGENCIES (TABLE 174.3) - p. 2832 1599. 175 Reconstruction of the Tympanic Membrane and Ossicular Chain - p. 2837 1600. INTRODUCTION - p. 2837 1601. DEFINITION OF TERMS - p. 2837 1602. TYPES OF TYMPANOPLASTY AND OSSICULAR RECONSTRUCTION - p. 2837 1603. PHYSIOLOGY: MECHANISMS OF GAIN - p. 2838 1604. PREOPERATIVE EVALUATION - p. 2839 1605. TYMPANOPLASTY - p. 2841 1606. OSSICULOPLASTY - p. 2849 1607. RESULTS - p. 2856 1608. 176 Otosclerosis - p. 2859 1609. EMBRYOLOGY - p. 2859 1610. HISTOLOGY - p. 2859 1611. BASIC SCIENCE - p. 2860 1612. PATHOPHYSIOLOGY - p. 2860 1613. EPIDEMIOLOGY - p. 2861 1614. HISTORY AND PHYSICAL EXAMINATION - p. 2862 1615. AUDIOLOGIC TESTING - p. 2862 1616. DIFFERENTIAL DIAGNOSIS - p. 2862 1617. MANAGEMENT - p. 2864 1618. AMPLIFICATION - p. 2864 1619. MEDICAL MANAGEMENT - p. 2865 1620. SURGICAL MANAGEMENT - p. 2865 1621. PATIENT SELECTION AND CONTRAINDICATIONS - p. 2866 1622. ENDOSCOPIC STAPES SURGERY - p. 2867 1623. PATIENT COUNSELING - p. 2867 1624. SURGICAL TECHNIQUE - p. 2867 1625. COMPLICATIONS/PITFALLS - p. 2873 1626. 177 Acute Paralysis of the Facial Nerve - p. 2877 1627. INTRODUCTION - p. 2877 1628. ANATOMY AND PHYSIOLOGY OF THE FACIAL NERVE - p. 2877 1629. SURGICAL ANATOMY - p. 2878 1630. EVALUATION - p. 2879 1631. PATHOPHYSIOLOGY OF NERVE INJURY - p. 2882 1632. BELL PALSY - p. 2884 1633. HERPES ZOSTER OTICUS - p. 2886 1634. OTITIS MEDIA AND FACIAL PALSY - p. 2887 1635. TRAUMA - p. 2887 1636. TUMORS OF THE SKULL BASE AND FACIAL NERVE - p. 2890 1637. FACIAL PALSY IN THE NEWBORN - p. 2891 1638. EYE CARE - p. 2892 1639. 178 Otologic Manifestations of Systemic Disease - p. 2895 1640. INTRODUCTION - p. 2895 1641. INFECTIOUS DISEASE - p. 2895 1642. GRANULOMATOUS DISEASE - p. 2898 1643. AUTOIMMUNE DISEASE - p. 2899 1644. INFLAMMATORY DISEASE - p. 2903 1645. DISEASES OF BONE - p. 2903 1646. METABOLIC DISORDERS - p. 2905 1647. PARANEOPLASTIC SYNDROMES AND MALIGNANCY - p. 2905 1648. 179 Noise-Induced Hearing Loss - p. 2909 1649. INTRODUCTION - p. 2909 1650. PATHOGENESIS - p. 2909 1651. EVALUATION AND DIAGNOSIS - p. 2919 1652. MANAGEMENT - p. 2924 1653. NONAUDITORY EFFECTS - p. 2926 1654. THE IMPORTANCE OF PREVENTION - p. 2926 1655. ACKNOWLEDGMENTS - p. 2927 1656. 180 Ototoxicity - p. 2936 1657. INTRODUCTION - p. 2936 1658. SYSTEMIC OTOTOXICITY - p. 2936 1659. TOPICAL OTOTOXICITY - p. 2938 1660. GENETICS OF OTOTOXICITY - p. 2939 1661. OTOPROTECTIVE STRATEGIES - p. 2940 1662. CLINICAL MONITORING OF OTOTOXICITY - p. 2941 1663. 181 Cerebrospinal Fluid Otorrhea - p. 2950 1664. INTRODUCTION - p. 2950 1665. PATHOPHYSIOLOGY - p. 2950 1666. DIAGNOSIS AND WORKUP - p. 2950 1667. TREATMENT - p. 2953 1668. CONCLUSION - p. 2957 1669. 182 Cerebellopontine Angle Tumors - p. 2959 1670. INTRODUCTION - p. 2959 1671. EXTRA-AXIAL LESIONS - p. 2961 1672. INTRA-AXIAL LESIONS - p. 2980 1673. SKULL BASE LESIONS - p. 2980 1674. CONCLUSION - p. 2984 1675. 183 Other Neoplasms of the Ear and Lateral Skull Base - p. 2991 1676. INTRODUCTION - p. 2991 1677. NEOPLASMS OF THE EXTERNAL EAR AND EXTERNAL AUDITORY CANAL - p. 2991 1678. NEOPLASMS OF THE MIDDLE EAR, MASTOID, AND TEMPORAL BONE - p. 3004 1679. NEOPLASMS OF THE INTERNAL AUDITORY CANAL AND CEREBELLOPONTINE ANGLE - p. 3012 1680. NEOPLASMS OF CELL-SPECIFIC ORIGIN - p. 3017 1681. METASTATIC DISEASE OF THE TEMPORAL BONE AND LATERAL SKULL BASE - p. 3026 1682. SURGICAL APPROACHES - p. 3027 1683. SUMMARY - p. 3028 1684. QUALITY OF LIFE AND REHABILITATION OF CRANIAL NERVE DEFICITS - p. 3029 1685. 184 Stereotactic Radiosurgery - p. 3035 1686. PRINCIPALS OF RADIATION THERAPY - p. 3035 1687. GAMMA KNIFE RADIOSURGERY - p. 3036 1688. PATIENT SELECTION - p. 3036 1689. ALTERNATIVE STEREOTACTIC RADIOSURGERY TECHNOLOGIES - p. 3053 1690. ALTERNATIVE APPLICATIONS - p. 3056 1691. SUMMARY - p. 3058 1692. 185 Sudden Sensorineural Hearing Loss - p. 3060 1693. INTRODUCTION - p. 3060 1694. BACKGROUND - p. 3060 1695. DIFFERENTIAL DIAGNOSIS - p. 3060 1696. EVALUATION - p. 3062 1697. TREATMENT - p. 3063 1698. RESULTS - p. 3065 1699. OUTCOMES ASSESSMENT AND PROGNOSIS - p. 3067 1700. COUNSELING AND REHABILITATION - p. 3067 1701. CONCLUSION - p. 3067 1702. 186 Tinnitus and Hyperacusis - p. 3071 1703. INTRODUCTION - p. 3071 1704. HISTORY AND PHYSICAL EXAMINATION - p. 3071 1705. SUBJECTIVE NONPULSATILE TINNITUS - p. 3073 1706. PULSATILE TINNITUS - p. 3080 1707. DIAGNOSTIC EVALUATION - p. 3080 1708. 187 Aging and the Auditory and Vestibular System - p. 3090 1709. INTRODUCTION - p. 3090 1710. AGING AND THE AUDITORY SYSTEM - p. 3090 1711. AGING AND THE VESTIBULAR SYSTEM - p. 3096 1712. CONCLUSION - p. 3100 1713. 188 Cochlear Implants and Other Implantable Auditory Prostheses - p. 3105 1714. INTRODUCTION - p. 3105 1715. COCHLEAR IMPLANTS - p. 3105 1716. BONE CONDUCTION IMPLANTS - p. 3121 1717. ACTIVE MIDDLE EAR IMPLANTS - p. 3129 1718. AUDITORY CNS IMPLANTS - p. 3134 1719. ACKNOWLEDGMENTS - p. 3136 1720. 189 “Heads Up” Ear Surgery: Endoscopes for Otology and Neurotology - p. 3141 1721. INTRODUCTION - p. 3141 1722. JUSTIFICATION FOR ENDOSCOPIC EAR SURGERY - p. 3141 1723. TERMINOLOGY AND CLASSIFICATION SYSTEMS - p. 3143 1724. APPLICATIONS OF ENDOSCOPIC EAR SURGERY IN OTOLOGY AND NEUROTOLOGY - p. 3143 1725. SURGICAL ERGONOMICS FOR ENDOSCOPIC EAR SURGERY - p. 3149 1726. INCORPORATING ENDOSCOPIC EAR SURGERY INTO CLINICAL PRACTICE - p. 3150 1727. CONCLUSION - p. 3152 1728. 190 Hearing Aids and Assistive Listening Devices - p. 3157 1729. POPULATION - p. 3157 1730. GOAL OF AMPLIFICATION - p. 3158 1731. BASICS OF THE AMPLIFICATION SYSTEM - p. 3158 1732. HEARING AID FITTING PROTOCOLS - p. 3158 1733. HEARING LOSS AND CANDIDACY - p. 3158 1734. EVALUATION - p. 3159 1735. PRESELECTION DECISIONS - p. 3160 1736. HEARING AID FITTING - p. 3168 1737. PRESETTING AND VERIFICATION - p. 3172 1738. ORIENTATION - p. 3174 1739. OUTCOME ASSESSMENT - p. 3174 1740. ASSISTIVE TECHNOLOGY BEYOND THE HEARING AID - p. 3175 1741. PROBLEMS FREQUENTLY ENCOUNTERED BY HEARING AID USERS IN HEALTH CARE SETTINGS - p. 3176 1742. CONCLUSION - p. 3176 1743. ACKNOWLEDGMENTS - p. 3176 1744. 191 Clinical Evaluation of the Patient with Vertigo - p. 3182 1745. INTRODUCTION - p. 3182 1746. HISTORY TAKING - p. 3184 1747. OFFICE NEUROTOLOGIC EXAMINATION - p. 3191 1748. EMERGENCY ROOM NEUROTOLOGIC EXAMINATION OF PATIENTS WITH ACUTE VESTIBULAR SYNDROME - p. 3207 1749. CONCLUSION - p. 3208 1750. 192 Peripheral Vestibular Disorders - p. 3212 1751. GENERAL PRINCIPLES - p. 3212 1752. BRIEF EPISODIC EXCITATION OF UNILATERAL VESTIBULAR FUNCTION - p. 3213 1753. EPISODIC DISRUPTION OF UNILATERAL VESTIBULAR FUNCTION - p. 3218 1754. CHRONICALLY INADEQUATE VESTIBULAR FUNCTION - p. 3224 1755. 193 Central Vestibular Disorders - p. 3231 1756. INTRODUCTION - p. 3231 1757. CANVAS - p. 3248 1758. 194 Vestibular Rehabilitation - p. 3259 1759. INTRODUCTION AND BACKGROUND - p. 3259 1760. AUDIOLOGIST’S ROLE IN VESTIBULAR REHABILITATION - p. 3260 1761. PHYSICAL THERAPIST’S ROLE IN VR - p. 3261 1762. CONCLUSION - p. 3262 1763. VIDEO SUPPLEMENT TO TEXT - p. 3263 1764. 195 Regenerative Strategies for Overcoming Deafness - p. 3265 1765. INTRODUCTION - p. 3265 1766. HAIR CELL REGENERATION, NONMAMMALIAN VERTEBRATES VERSUS MAMMALS - p. 3265 1767. NOTCH AND WNT PATHWAYS - p. 3266 1768. Atoh1 Gene Therapy - p. 3267 1769. CELL CYCLE INHIBITION - p. 3267 1770. SOMATIC STEM CELLS - p. 3268 1771. EMBRYONIC STEM CELLS AND INDUCED PLURIPOTENT STEM CELLS - p. 3268 1772. ORGANOIDS AS A MODEL TO STUDY HAIR CELL REGENERATION - p. 3269 1773. SUMMARY - p. 3270 1774. ACKNOWLEDGMENTS - p. 3270 1775. SECTION X: FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY - p. 3273 1776. 196 Preoperative Evaluation and Facial Analysis in Facial Plastic Surgery - p. 3275 1777. CONCEPT OF BEAUTY AND DEFORMITY - p. 3275 1778. INITIAL CONSULTATION - p. 3275 1779. PSYCHOPATHOLOGY IN THE AESTHETIC PATIENT - p. 3276 1780. FACIAL ANALYSIS - p. 3277 1781. METHODS OF FACIAL ANALYSIS - p. 3287 1782. CONCLUSION - p. 3288 1783. 197 Fundamentals of Photography for the Otolaryngologist - p. 3291 1784. INTRODUCTION - p. 3291 1785. INFORMED CONSENT - p. 3291 1786. CAMERA AND EQUIPMENT - p. 3291 1787. LIGHTING, BACKGROUND, AND PATIENT POSITIONING - p. 3296 1788. COMPUTER IMAGING SIMULATION - p. 3297 1789. INTRAOPERATIVE PHOTOGRAPHS - p. 3299 1790. DIGITAL IMAGE STORAGE, POSTPROCESSING, AND MANAGEMENT - p. 3300 1791. CONCLUSION - p. 3300 1792. 198 Local Cutaneous Flaps and Grafts - p. 3302 1793. INTRODUCTION - p. 3302 1794. SKIN ANATOMY - p. 3302 1795. SKIN BIOMECHANICAL PROPERTIES - p. 3303 1796. SKIN PHYSIOLOGY - p. 3304 1797. DEFECT ANALYSIS AND PREPARATION - p. 3305 1798. PATIENT PREPARATION—MEDICAL COMORBIDITIES - p. 3306 1799. HEALING BY SECONDARY INTENTION - p. 3307 1800. PRIMARY CLOSURE - p. 3307 1801. FACIAL CUTANEOUS FLAPS - p. 3307 1802. FACIAL CUTANEOUS GRAFTS - p. 3318 1803. COMPLICATIONS - p. 3323 1804. 199 Tissue Expanders - p. 3329 1805. INTRODUCTION - p. 3329 1806. SKIN BIOMECHANICS AND TYPES OF EXPANSION - p. 3329 1807. PHYSIOLOGY OF TISSUE EXPANSION - p. 3331 1808. APPLICATIONS - p. 3331 1809. EXPANDER DEVICES - p. 3332 1810. SURGICAL TECHNIQUES: CONVENTIONAL LONG-TERM TISSUE EXPANSION - p. 3333 1811. SURGICAL TECHNIQUES: RAPID INTRAOPERATIVE TISSUE EXPANSION - p. 3334 1812. COMPLICATIONS - p. 3337 1813. CONCLUSION - p. 3337 1814. 200 Scar Camouflage - p. 3339 1815. INTRODUCTION - p. 3339 1816. BASIC SCIENCE - p. 3339 1817. SURGICAL TECHNIQUES - p. 3340 1818. NONSURGICAL AND ADJUNCTIVE TECHNIQUES - p. 3346 1819. 201 Nasal Reconstruction - p. 3351 1820. INTRODUCTION - p. 3351 1821. HISTORY OF NASAL RECONSTRUCTION - p. 3351 1822. ETIOLOGY OF NASAL DEFECTS - p. 3352 1823. NASAL ANATOMY - p. 3352 1824. DEFECT ANALYSIS - p. 3356 1825. SMALL CUTANEOUS DEFECTS - p. 3357 1826. SELECTION OF GRAFTS AND FLAPS - p. 3358 1827. TECHNIQUES FOR GRAFTS AND FLAPS - p. 3359 1828. LARGE CUTANEOUS DEFECTS - p. 3368 1829. STRUCTURAL SUPPORT AND GRAFTING IN NASAL RECONSTRUCTION - p. 3378 1830. INTERNAL LINING DEFICITS - p. 3383 1831. COMPLICATIONS AND MANAGEMENT - p. 3393 1832. CONCLUSION - p. 3396 1833. 202 Lip Reconstruction - p. 3400 1834. INTRODUCTION - p. 3400 1835. ANATOMY - p. 3400 1836. MANAGEMENT OF LIP DEFECTS - p. 3402 1837. RECONSTRUCTIVE TECHNIQUES - p. 3403 1838. ACKNOWLEDGMENT - p. 3414 1839. 203 Auricular Reconstruction - p. 3415 1840. AURICULAR RECONSTRUCTION - p. 3415 1841. PREOPERATIVE CONSIDERATIONS - p. 3415 1842. ETIOLOGY - p. 3416 1843. ONCOLOGIC CONSIDERATIONS - p. 3416 1844. TRAUMATIC CONSIDERATIONS - p. 3417 1845. ANATOMY - p. 3417 1846. GENERAL PRINCIPLES OF RECONSTRUCTION - p. 3418 1847. LACERATIONS - p. 3420 1848. SUPERFICIAL DEFECTS - p. 3420 1849. SMALLER COMPOSITE DEFECTS - p. 3421 1850. CONCLUSION - p. 3444 1851. 204 Periorbital Reconstruction - p. 3446 1852. INTRODUCTION - p. 3446 1853. ANATOMY - p. 3446 1854. EVALUATION - p. 3451 1855. PRINCIPLES OF RECONSTRUCTION - p. 3452 1856. RECONSTRUCTIVE TECHNIQUES - p. 3453 1857. COMPLICATIONS - p. 3460 1858. BLEPHAROPTOSIS - p. 3462 1859. RECONSTRUCTION OF THE PARALYTIC EYELID - p. 3463 1860. CICATRICIAL ECTROPION - p. 3463 1861. MANAGEMENT OF THE EYELIDS IN POSTMAXILLECTOMY DEFECTS - p. 3465 1862. CONCLUSION - p. 3466 1863. 205 Facial Reanimation - p. 3468 1864. INTRODUCTION - p. 3468 1865. CLASSIFICATION OF FACIAL PALSY AND NERVE INJURY - p. 3468 1866. GLOBAL MANAGEMENT OF FACIAL PALSY - p. 3469 1867. FACIAL MANAGEMENT BY ZONE - p. 3472 1868. CONCLUSION - p. 3481 1869. 206 Surgical Anatomy of the Nose: A Foundation for Rhinoplasty - p. 3483 1870. GENERAL PRINCIPLES - p. 3483 1871. SURFACE ANATOMY - p. 3483 1872. SKIN–SOFT TISSUE ENVELOPE - p. 3488 1873. SKELETAL FRAMEWORK - p. 3490 1874. NASAL BASE - p. 3496 1875. MECHANICS AND STABILITY - p. 3497 1876. FUNCTIONAL VALVULAR ANATOMY - p. 3501 1877. ETHNIC VARIATIONS - p. 3502 1878. CONCLUSION - p. 3502 1879. 207 Rhinoplasty: Incisions, Approaches, and Analysis - p. 3505 1880. INTRODUCTION - p. 3505 1881. ANATOMIC LANDMARKS - p. 3505 1882. NASAL AND FACIAL ANGLES - p. 3506 1883. SURGICAL INCISIONS AND APPROACHES - p. 3507 1884. NASAL ANALYSIS - p. 3510 1885. CONCLUSION - p. 3514 1886. 208 The Nasal Dorsum: Management of the Upper Two-Thirds of the Nose - p. 3516 1887. INTRODUCTION - p. 3516 1888. ANATOMY - p. 3516 1889. NASAL ANALYSIS - p. 3518 1890. DEFECTS OF THE NASAL VAULTS - p. 3520 1891. MANAGEMENT OF THE CARTILAGINOUS VAULT - p. 3521 1892. MANAGEMENT OF THE BONY VAULT - p. 3522 1893. CONCLUSION - p. 3530 1894. 209 Management of Nasal Tip and Alar Base - p. 3532 1895. INTRODUCTION - p. 3532 1896. ANALYSIS AND DIAGNOSIS - p. 3532 1897. PREOPERATIVE PLANNING - p. 3538 1898. SURGICAL TECHNIQUES - p. 3538 1899. 210 Management of the Crooked Nose - p. 3550 1900. INTRODUCTION - p. 3550 1901. ANALYSIS - p. 3550 1902. ETIOLOGY - p. 3552 1903. ANATOMY - p. 3552 1904. MANAGEMENT - p. 3554 1905. COMPLICATIONS - p. 3562 1906. CONCLUSION - p. 3563 1907. 211 Functional Septorhinoplasty - p. 3564 1908. INTRODUCTION - p. 3564 1909. CAUSES OF NASAL OBSTRUCTION - p. 3564 1910. EVALUATION OF THE PATIENT PRESENTING WITH NASAL OBSTRUCTION - p. 3569 1911. TREATMENT OF NASAL VALVE COMPROMISE - p. 3570 1912. 212 Revision Rhinoplasty - p. 3579 1913. INTRODUCTION - p. 3579 1914. ASSESSING NASAL DEFORMITY AND SURGICAL INTOLERANCE - p. 3579 1915. PATIENT EVALUATION AND TREATMENT PLANNING - p. 3581 1916. SURGICAL RECONSTRUCTION OF THE PREVIOUSLY OPERATED NOSE - p. 3586 1917. AUGMENTATION GRAFTING OF THE OVERRESECTED NOSE - p. 3589 1918. OPTIONS FOR SKELETAL TISSUE REPLACEMENT - p. 3590 1919. EXTERNAL RHINOPLASTY APPROACH - p. 3596 1920. SOFT TISSUE SURGICAL TECHNIQUE - p. 3596 1921. SURGICAL DECONSTRUCTION OF THE PREVIOUSLY OPERATED NOSE - p. 3597 1922. RECONSTRUCTION OF THE SURGICALLY DEVASTATED NASAL TIP - p. 3599 1923. REVISION OF THE SURGICALLY DEVASTATED NASAL DORSUM - p. 3607 1924. AFTERCARE - p. 3613 1925. CONCLUSION - p. 3635 1926. 213 Cleft Septorhinoplasty - p. 3638 1927. INTRODUCTION - p. 3638 1928. RELEVANT EMBRYOLOGY - p. 3638 1929. RELEVANT CLINICAL ANATOMY - p. 3638 1930. UNILATERAL CLEFT LIP - p. 3639 1931. BILATERAL CLEFT LIP - p. 3640 1932. PRESURGICAL MANAGEMENT PRIOR TO THE PRIMARY CLEFT LIP REPAIR - p. 3641 1933. STAGES OF CLEFT SEPTORHINOPLASTY - p. 3643 1934. PRIMARY CLEFT RHINOPLASTY - p. 3643 1935. INTERMEDIATE CLEFT RHINOPLASTY - p. 3645 1936. DEFINITIVE CLEFT RHINOPLASTY - p. 3645 1937. AVOIDING COMPLICATIONS - p. 3648 1938. CONCLUSION - p. 3649 1939. 214 The Aging Forehead - p. 3651 1940. HISTORY - p. 3651 1941. FOREHEAD ANATOMY - p. 3651 1942. PHYSIOLOGY OF AGING - p. 3653 1943. BROW AESTHETICS - p. 3654 1944. ASSESSMENT - p. 3654 1945. PREOPERATIVE COUNSELING - p. 3655 1946. MANAGEMENT - p. 3656 1947. SURGICAL PROCEDURE AND TECHNIQUE - p. 3656 1948. COMPLICATIONS - p. 3670 1949. EMERGENCIES - p. 3672 1950. CONCLUSION - p. 3672 1951. 215 Upper Eyelid Blepharoplasty - p. 3675 1952. INTRODUCTION - p. 3675 1953. SURGICAL ANATOMY - p. 3675 1954. EVALUATION - p. 3678 1955. PHOTOGRAPHY - p. 3682 1956. GOALS OF SURGERY - p. 3682 1957. COMPLICATIONS - p. 3684 1958. CONCLUSION - p. 3685 1959. 216 Lower Eyelid Blepharoplasty - p. 3686 1960. LOWER EYELID ANATOMY - p. 3686 1961. IMPORTANT TERMINOLOGY - p. 3686 1962. PATIENT SELECTION AND EXAMINATION - p. 3687 1963. PHOTOGRAPHY AND CONSENTS - p. 3690 1964. SURGICAL PROCEDURE - p. 3690 1965. ADJUNCTIVE PROCEDURES - p. 3695 1966. COMPLICATIONS - p. 3700 1967. CONCLUSION - p. 3702 1968. ACKNOWLEDGMENT - p. 3702 1969. 217 Rhytidectomy and Platysmaplasty (Face-Lift and Neck Lift) - p. 3704 1970. INTRODUCTION - p. 3704 1971. GENERAL CONSIDERATIONS AND ADJUNCTIVE PROCEDURES - p. 3704 1972. PHYSIOLOGY OF THE AGING FACE - p. 3705 1973. SURGICAL ANATOMY - p. 3706 1974. SURGICAL EVOLUTION: A HISTORICAL PERSPECTIVE - p. 3708 1975. ASSESSING CANDIDACY - p. 3711 1976. PREOPERATIVE EVALUATION AND PLANNING - p. 3712 1977. PREOPERATIVE PREPARATION - p. 3714 1978. SURGICAL PLANNING - p. 3714 1979. OPERATIVE STAGE - p. 3717 1980. DEEP PLANE LIFT - p. 3722 1981. SPECIAL CONSIDERATIONS - p. 3727 1982. POSTOPERATIVE CARE - p. 3730 1983. COMPLICATIONS - p. 3731 1984. 218 Otoplasty: Anatomy, Embryology, and Otoplasty Technique - p. 3738 1985. INTRODUCTION - p. 3738 1986. ANATOMY AND EMBRYOLOGY - p. 3738 1987. AURICULAR ANOMALIES - p. 3740 1988. PATIENT SELECTION - p. 3743 1989. SURGICAL TECHNIQUES - p. 3744 1990. LONG-TERM RESULTS - p. 3754 1991. CONCLUSION - p. 3754 1992. 219 Congenital Auricular Malformation - p. 3757 1993. MICROTIA - p. 3757 1994. ANATOMY AND EMBRYOLOGY - p. 3757 1995. CLASSIFICATION - p. 3759 1996. HISTORY - p. 3759 1997. EVALUATION - p. 3761 1998. MATERIALS FOR RECONSTRUCTION - p. 3761 1999. SURGICAL PLANNING - p. 3764 2000. TECHNIQUES - p. 3765 2001. COMPLICATIONS - p. 3769 2002. EAR MOLDING - p. 3771 2003. AURICULAR PROSTHETICS - p. 3772 2004. CONCLUSION - p. 3772 2005. ACKNOWLEDGEMENT - p. 3772 2006. 220 Chin Augmentation - p. 3774 2007. INTRODUCTION - p. 3774 2008. PATIENT EVALUATION - p. 3774 2009. CLASSIFICATION OF CHIN DEFORMITIES - p. 3778 2010. SELECTION OF PROCEDURE - p. 3780 2011. PROCEDURAL DETAILS - p. 3780 2012. COMPLICATIONS - p. 3785 2013. CONCLUSION - p. 3786 2014. 221 Facial Resurfacing - p. 3788 2015. INTRODUCTION - p. 3788 2016. ANATOMY OF THE SKIN - p. 3788 2017. CONTRAINDICATIONS TO RESURFACING PROCEDURES - p. 3789 2018. ABLATIVE VERSUS NONABLATIVE RESURFACING - p. 3789 2019. PREPROCEDURE SKIN PREPARATION - p. 3789 2020. CHEMICAL PEELS - p. 3790 2021. LASER RESURFACING - p. 3793 2022. DERMABRASION - p. 3796 2023. COMBINED RESURFACING PROCEDURES - p. 3796 2024. POSTPROCEDURE SKIN CARE - p. 3797 2025. RESURFACING COMPLICATIONS - p. 3798 2026. CONCLUSION - p. 3799 2027. 222 Management of Benign Facial Lesions - p. 3801 2028. INTRODUCTION - p. 3801 2029. HISTORY AND PHYSICAL EXAMINATION - p. 3801 2030. EPIDERMAL LESIONS - p. 3801 2031. SKIN APPENDAGE TUMORS - p. 3802 2032. NON–SKIN APPENDAGE TUMORS - p. 3805 2033. LABORATORY STUDIES - p. 3808 2034. THERAPEUTIC CONSIDERATIONS: TECHNIQUES AND INSTRUMENTATION - p. 3809 2035. TREATMENT OF SPECIFIC LESIONS - p. 3813 2036. 223 Congenital Vascular Lesions of the Head and Neck - p. 3818 2037. CLASSIFICATION AND MANAGEMENT OF CONGENITAL VASCULAR ANOMALIES - p. 3818 2038. SPECIAL CONSIDERATIONS - p. 3820 2039. VASCULAR MALFORMATIONS - p. 3825 2040. TREATMENT - p. 3828 2041. SUMMARY - p. 3838 2042. 224 Management of Alopecia - p. 3840 2043. INTRODUCTION - p. 3840 2044. MEDICAL TREATMENT OF ANDROGENIC ALOPECIA - p. 3840 2045. SURGICAL TREATMENT OF ALOPECIA - p. 3841 2046. FEMALE PATTERN HAIR LOSS - p. 3848 2047. ANESTHESIA - p. 3849 2048. AUTOGRAFT HAIR TRANSPLANTATION - p. 3849 2049. SCALP REDUCTIONS AND SCALP FLAPS - p. 3852 2050. HAIRLINE LOWERING/FOREHEAD REDUCTION SURGERY - p. 3852 2051. TISSUE EXPANSION - p. 3854 2052. HAIR TRANSPLANTATION TO THE NONSCALP - p. 3854 2053. 225 Injectables for Facial Rejuvenation - p. 3857 2054. INTRODUCTION - p. 3857 2055. APPROACH TO AGE-RELATED CHANGES TO FACIAL ANATOMY - p. 3857 2056. BOTULINUM TOXIN - p. 3859 2057. FACIAL FILLERS - p. 3864 2058. NECK CONTOURING AND CHEMICAL LIPOLYSIS - p. 3869 2059. CONCLUSION - p. 3869 2060. SECTION XI: CONTEMPORARY ISSUES IN MEDICAL PRACTICE - p. 3873 2061. 226 Patient Safety in Otolaryngology - p. 3875 2062. INTRODUCTION - p. 3875 2063. FUNDAMENTALS OF PATIENT SAFETY AND QUALITY IMPROVEMENT - p. 3875 2064. CASE 1 - p. 3878 2065. INSTITUTIONAL STRATEGIES TO ENSURE PATIENT SAFETY - p. 3879 2066. SPECIFIC QUALITY IMPROVEMENT ISSUES IN OTOLARYNGOLOGY - p. 3883 2067. CONCLUSION - p. 3884 2068. 227 Legal and Regulatory Considerations for the Otorhinolaryngologist—Head and Neck Surgeon - p. 3887 2069. INTRODUCTION - p. 3887 2070. MEDICAL MALPRACTICE - p. 3887 2071. CREDENTIALING AND PRIVILEGING - p. 3892 2072. COMPLIANCE PROGRAMS - p. 3893 2073. CONCLUSION - p. 3896 2074. 228 Coding in Otolaryngology - p. 3898 2075. HISTORY OF CODING - p. 3898 2076. CODING BASICS - p. 3899 2077. OFFICE CODING - p. 3900 2078. SURGICAL CODING - p. 3902 2079. CONCLUSION - p. 3905 2080. 229 Building a Comprehensive Outpatient Otolaryngology Practice - p. 3906 2081. INTRODUCTION - p. 3906 2082. HUMAN RESOURCES - p. 3906 2083. OFFICE EFFICIENCY - p. 3909 2084. INFORMATION TECHNOLOGY - p. 3910 2085. MARKETING - p. 3911 2086. SAFETY AND QUALITY - p. 3912 2087. PHYSICIAN EXTENDERS AND ANCILLARY SERVICES - p. 3913 2088. CONCLUSION - p. 3915 2089. 230 Databases Driving Improvement - p. 3918 2090. INTRODUCTION - p. 3918 2091. ADMINISTRATIVE DATABASES - p. 3919 2092. CLINICAL REGISTRIES - p. 3922 2093. CONCLUSION - p. 3926 2094. 231 Telemedicine for Otolaryngology - p. 3931 2095. INTRODUCTION - p. 3931 2096. DEFINITIONS - p. 3931 2097. DIRECT TO CONSUMER TECHNOLOGY - p. 3933 2098. SECURITY, HIPAA, AND THE COVID-19 PANDEMIC - p. 3934 2099. USES OF TELEMEDICINE IN OTOLARYNGOLOGY - p. 3934 2100. BARRIERS TO ADOPTION - p. 3939 2101. 232 Quality Improvement in Otolaryngology - p. 3944 2102. INTRODUCTION - p. 3944 2103. HISTORICAL BACKGROUND - p. 3944 2104. THE ROLE OF MEASUREMENT IN QI - p. 3945 2105. ORGANIZATIONS ENDORSING QUALITY MEASURES OR MEASURING QUALITY - p. 3947 2106. EXTERNAL REQUIREMENTS FOR QUALITY - p. 3948 2107. QUALITY WITHIN HEALTH CARE INSTITUTIONS AND SYSTEMS - p. 3948 2108. QUALITY AND REIMBURSEMENT - p. 3949 2109. COMPLEX SYSTEMS AND HIGH PERFORMANCE WITHIN SYSTEMS - p. 3949 2110. A PRIMER ON LOCAL QI INITIATIVES - p. 3950 2111. CONCLUSION - p. 3950 2112. 233 Conflict of Interest - p. 3952 2113. INTRODUCTION - p. 3952 2114. DEFINITION OF CONFLICT OF INTEREST - p. 3952 2115. CONFLICT OF INTEREST IN PUBLISHING - p. 3953 2116. CONFLICT OF INTEREST IN RESEARCH - p. 3956 2117. INSTITUTIONAL CONFLICT OF INTEREST - p. 3956 2118. CONFLICT OF INTEREST IN MEDICAL PRACTICE - p. 3957 2119. CONFLICT OF INTEREST IN CONTINUING MEDICAL EDUCATION - p. 3958 2120. SPECIFIC RULES GOVERNING CONFLICTS IN INDUSTRY - p. 3958 2121. BEST PRACTICES - p. 3960 2122. 234 Anatomy: Functional Etymology - p. 3963 2123. INTRODUCTION - p. 3963 2124. RHINOLOGY/SKULL BASE - p. 3963 2125. OTOLOGY - p. 3964 2126. OTHER - p. 3966 2127. 235 Individual and System Solutions for Physician/Provider Well-Being - p. 3968 2128. DEDICATION - p. 3968 2129. INTRODUCTION - p. 3968 2130. WELLNESS AND WELL-BEING - p. 3969 2131. DEFINITIONS - p. 3970 2132. PHYSICIAN SUICIDE - p. 3971 2133. CREATING CULTURE CHANGE TO NORMALIZE NEED AND ASKING FOR HELP - p. 3972 2134. MENTAL HEALTH COMPONENT - p. 3972 2135. PHYSICAL HEALTH COMPONENT - p. 3975 2136. SELF-COMPASSION - p. 3978 2137. PLAN VACATIONS, TIME AWAY, AND “MIND AWAY” TIMES - p. 3979 2138. LEARN WHAT YOU DON’T KNOW OR ARE UNCOMFORTABLE WITH - p. 3979 2139. SUMMARY - p. 3980 2140. AUTHOR’S FAVORITE QUOTES - p. 3980 2141. ACKNOWLEDGMENTS - p. 3980 2142. ADDITIONAL ACKNOWLEDGMENTS - p. 3980 2143. 236 Simulation in Otolaryngology - p. 3983 2144. INTRODUCTION - p. 3983 2145. SIMULATORS AND SIMULATIONS - p. 3983 2146. SIMULATIONS TO IMPROVE THE SKILLS OF INDIVIDUALS - p. 3987 2147. SIMULATIONS FOR TEAMS - p. 3987 2148. SIMULATION FOR SYSTEM IMPROVEMENT - p. 3987 2149. TEACHING VERSUS ASSESSMENT USING SIMULATION - p. 3989 2150. UNIQUE APPLICATIONS OF SIMULATION - p. 3990 2151. SIMULATION PROGRAM DEVELOPMENT - p. 3991 2152. FUTURE - p. 3991 2153. 237 Cognitive and Implicit Bias - p. 3993 2154. INTRODUCTION - p. 3993 2155. TO ERR IS INDEED HUMAN - p. 3993 2156. COMMON COGNITIVE HEURISTICS AND BIASES - p. 3994 2157. EFFECTS OF COGNITIVE BIASES ON HEALTH CARE - p. 3995 2158. MITIGATION OF COGNITIVE BIAS EFFECTS - p. 3996 2159. IMPLICIT BIAS - p. 3997 2160. EFFECTS OF IMPLICIT BIASES ON HEALTH CARE - p. 3997 2161. MITIGATION OF IMPLICIT BIAS EFFECTS - p. 3998 2162. CONCLUSION - p. 3998 2163. 238 Ethics in Otolaryngology - p. 4001 2164. INTRODUCTION - p. 4001 2165. HISTORICAL BACKGROUND - p. 4001 2166. ETHICAL FRAMEWORKS FOR PRACTICE - p. 4002 2167. CLINICAL ETHICS IN OTOLARYNGOLOGY - p. 4003 2168. PROFESSIONAL ETHICS IN OTOLARYNGOLOGY - p. 4007 2169. CONCLUSION - p. 4010 2170. Index - p. I-1
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Designed to enhance the learning experience for both practicing otolaryngologists and otolaryngology residents, Bailey’s Head & Neck Surgery—Otolaryngology, 6th Edition, delivers concise, practical information in all areas of this complex field. Dr. Clark A. Rosen (Laryngology) and his hand-picked editorial team representing all of the sub-disciplines of Head & Neck Surgery-Otolaryngology of Drs. Stacey Gray (rhinology), Patrick Ha (Head and Neck Surgery), Charles Limb (Otology), Stephen Park (Facial Plastics and Reconstructive Surgery), and Gresham Richter (Pediatric Otolaryngology) ensure that all content in this two-volume text is current, useful, and evidence based. Each chapter has been written to increase the reader’s understanding, retention, and ability to successfully apply information in everyday practice.
1. INTRODUCTION - p. 3 2. THE CRANIUM - p. 3 3. CRANIAL FOSSAE - p. 4 4. EYELID, ORBIT, AND EYE - p. 5 5. THE EAR - p. 8 6. NOSE AND PARANASAL SINUSES - p. 10 7. THE FACE - p. 13 8. ORAL STRUCTURES - p. 14 9. PHARYNX AND LARYNX - p. 18 10. THE NECK - p. 20 11. 2 Perioperative Management - p. 25 12. INTRODUCTION - p. 25 13. PREOPERATIVE EVALUATION - p. 25 14. PREOPERATIVE MALNUTRITION - p. 25 15. HEMATOLOGIC ABNORMALITIES - p. 25 16. THROMBOEMBOLIC DISEASES - p. 27 17. ENDOCRINE ABNORMALITIES - p. 28 18. CARDIOVASCULAR DISORDERS - p. 29 19. PULMONARY DISORDERS - p. 30 20. GASTROINTESTINAL DISORDERS - p. 31 21. RENAL DISEASE - p. 32 22. NEUROPSYCHIATRIC PROBLEMS - p. 32 23. GENERAL CONSIDERATIONS - p. 33 24. GERIATRIC PATIENTS - p. 34 25. SURGERY IN THE CHEMICALLY OR ALCOHOL-DEPENDENT PATIENT - p. 35 26. ENHANCED RECOVERY AFTER SURGERY - p. 35 27. 3 Critical Care - p. 39 28. MECHANICAL VENTILATION - p. 39 29. TISSUE OXYGENATION AND ORGAN PERFUSION - p. 44 30. BLOOD TRANSFUSIONS IN THE ICU - p. 45 31. SHOCK - p. 47 32. VASOACTIVE AGENTS IN THE ICU - p. 48 33. PULMONARY EMBOLISM - p. 50 34. INFECTIONS - p. 50 35. ACUTE KIDNEY INJURY - p. 52 36. THE USE OF PERIOPERATIVE BETA BLOCKER PROPHYLAXIS IN THE ICU - p. 54 37. ATRIAL FIBRILLATION - p. 54 38. PAIN MANAGEMENT AND SEDATION IN THE ICU - p. 55 39. GASTRIC ACID SUPPRESSION - p. 57 40. PALLIATIVE CARE AND ICU - p. 58 41. 4 The Dynamics of Wound Healing - p. 61 42. INTRODUCTION - p. 61 43. THE NORMAL WOUND HEALING PROCESS - p. 61 44. FACTORS AFFECTING WOUND HEALING - p. 66 45. DERANGEMENTS OF WOUND HEALING - p. 69 46. METHODS TO IMPROVE WOUND HEALING - p. 70 47. CONCLUSION - p. 71 48. 5 Understanding Data and Interpreting the Literature - p. 72 49. INTRODUCTION - p. 72 50. HOW TO IDENTIFY ARTICLES WORTH READING - p. 72 51. FIVE BASIC QUESTIONS FOR INTERPRETING DATA - p. 73 52. THE FUTURE OF UNDERSTANDING DATA - p. 87 53. 6 Outcomes Research and Evidence-Based Medicine - p. 90 54. INTRODUCTION AND HISTORY - p. 90 55. DEFINITION OF OUTCOME - p. 90 56. TYPES OF STUDIES - p. 90 57. STEPS IN PERFORMING OUTCOMES RESEARCH - p. 91 58. RESULTS FROM OUTCOMES RESEARCH IN OTOLARYNGOLOGY - p. 93 59. OTHER TYPES OF OUTCOMES RESEARCH - p. 93 60. EVIDENCE-BASED MEDICINE - p. 94 61. EVIDENCE-BASED GUIDELINES - p. 97 62. 7 Introduction to Otolaryngic Genetics - p. 99 63. INTRODUCTION - p. 99 64. MOLECULAR BASIS OF INHERITANCE - p. 99 65. MENDELIAN GENETICS - p. 104 66. NONMENDELIAN GENETICS - p. 107 67. GENETIC DISORDERS IN OTOLARYNGOLOGY—HEAD AND NECK SURGERY - p. 114 68. DIAGNOSIS OF GENETIC DISORDERS - p. 118 69. MOLECULAR THERAPY IN GENETICS - p. 118 70. ACKNOWLEDGMENTS - p. 119 71. 8 Head and Neck Imaging - p. 124 72. INTRODUCTION - p. 124 73. IMAGING MODALITIES - p. 124 74. IMAGING APPLICATIONS BASED ON ANATOMIC LOCATION - p. 132 75. NEWER IMAGING MODALITIES AND THEIR APPLICATIONS - p. 144 76. CONCLUSION - p. 145 77. 9 Surgical Pathology in Otolaryngologic Practice - p. 148 78. INTRODUCTION - p. 148 79. THE PATHOLOGY LABORATORY - p. 148 80. BIOPSY TECHNIQUES - p. 148 81. PATHOLOGY AND THE OPERATING ROOM - p. 151 82. INTRAOPERATIVE CONSULTATION - p. 153 83. NECK DISSECTION SPECIMENS - p. 154 84. HEAD AND NECK HISTOPATHOLOGY - p. 155 85. SQUAMOUS CELL CARCINOMA AND ITS VARIANTS - p. 167 86. 10 Neurology in Otolaryngology - p. 171 87. INTRODUCTION - p. 171 88. ANATOMY AND CRANIAL NERVE FUNCTIONS - p. 171 89. CEREBROVASCULAR DISEASE - p. 171 90. MIGRAINE - p. 177 91. NEUROMUSCULAR DISORDERS - p. 181 92. NEOPLASMS - p. 185 93. CHIARI MALFORMATION - p. 186 94. NORMAL PRESSURE HYDROCEPHALUS - p. 187 95. 11 Ophthalmic Considerations for Otolaryngology—Head and Neck Surgery - p. 189 96. INTRODUCTION - p. 189 97. THE BASIC EYE EXAMINATION - p. 189 98. ORBITAL TRAUMA - p. 192 99. SINO-ORBITAL INFECTIONS AND INFLAMMATIONS - p. 193 100. NONINFECTIOUS ORBITAL INFLAMMATION - p. 196 101. SINO-ORBITAL NEOPLASMS - p. 198 102. LACRIMAL SURGERY - p. 198 103. OPHTHALMIC COMPLICATIONS OF FACIAL NERVE PALSY - p. 198 104. SYNDROMES OF HEARING AND VISUAL DYSFUNCTION - p. 199 105. 12 Anesthesiology - p. 203 106. INTRODUCTION - p. 203 107. PREOPERATIVE PREPARATION - p. 203 108. AIRWAY MANAGEMENT - p. 203 109. GENERAL ANESTHESIA - p. 207 110. ANCILLARY AGENTS - p. 210 111. LOCAL ANESTHESIA - p. 213 112. ANESTHESIA MONITORING - p. 215 113. ANESTHETIC CONSIDERATIONS FOR ENDOSCOPIC PROCEDURES - p. 216 114. 13 Endocrinology - p. 220 115. INTRODUCTION - p. 220 116. PITUITARY GLAND - p. 220 117. THE PARATHYROID GLAND AND CALCIUM HOMEOSTASIS - p. 223 118. THYROID GLAND - p. 229 119. ADRENAL GLANDS - p. 232 120. THE PANCREAS AND GLUCOSE METABOLISM - p. 234 121. INHERITED ENDOCRINE DISORDERS - p. 236 122. HORMONE SECRETING TUMORS - p. 237 123. 14 Basic Concepts in Geriatric Otolaryngology - p. 242 124. INTRODUCTION - p. 242 125. CONCEPTS IN AGING - p. 242 126. 15 Complementary/Integrative Medicine - p. 248 127. INTRODUCTION - p. 248 128. TYPES OF CIM - p. 248 129. CIM FOR THE OTOLARYNGOLOGIST - p. 252 130. COMMONLY USED CIM THERAPIES FOR OTOLARYNGOLOGIC CONDITIONS - p. 255 131. CONCLUSION - p. 258 132. 16 Tobacco Cessation: How-to Guidance and Resources for Practitioners - p. 263 133. BACKGROUND - p. 263 134. THE CLINICAL INTERVENTION - p. 264 135. BRIEF CLINICAL INTERVENTION - p. 264 136. MULTIMODALITY TREATMENT - p. 267 137. CESSATION PROGRAMS AND RESOURCES - p. 270 138. SMOKING CESSATION FOR THE SURGEON—PERIOPERATIVE CONSIDERATIONS - p. 271 139. CONCLUSION - p. 272 140. 17 Palliative Care and Pain Management - p. 275 141. INTRODUCTION - p. 275 142. PRESENTING SYMPTOMS AND ASSESSMENT OF PATIENTS WITH HNC - p. 276 143. PALLIATIVE ANTINEOPLASTIC THERAPIES - p. 277 144. PALLIATIVE CARE CLINICAL PRACTICE GUIDELINES - p. 278 145. PAIN IN HEAD AND NECK CANCER - p. 280 146. END-OF-LIFE CARE FOR PATIENTS WITH HNC - p. 286 147. CARE FOR THE CAREGIVER AND PHYSICIAN BURNOUT - p. 288 148. CONCLUSION - p. 289 149. 18 Global Respiratory Infections - p. 293 150. INTRODUCTION - p. 293 151. COVID-19 VIROLOGY AND AFFINITY FOR THE NASAL CAVITY AND NASOPHARYNX - p. 293 152. DISEASE TRANSMISSION - p. 294 153. CLINICAL FEATURES AND DIAGNOSIS - p. 295 154. CONSIDERATIONS FOR PRACTICE - p. 295 155. VIRAL-ASSOCIATED OLFACTORY LOSS - p. 296 156. COVID-19 IN CHILDREN AND MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) - p. 296 157. CONCLUSION - p. 297 158. SECTION II: RHINOLOGY AND ALLERGY - p. 299 159. 19 Sinonasal Anatomy and Physiology - p. 301 160. EMBRYOLOGY - p. 301 161. ANATOMY - p. 301 162. ANATOMIC CAUSES OF NASAL OBSTRUCTION - p. 305 163. PHYSIOLOGY - p. 307 164. 20 Olfaction - p. 313 165. INTRODUCTION - p. 313 166. ANATOMY - p. 313 167. PHYSIOLOGY OF OLFACTION - p. 315 168. ETIOLOGY OF OLFACTORY LOSS - p. 315 169. EVALUATION - p. 316 170. PHANTOSMIA/DYSOSMIA CONSIDERATIONS - p. 318 171. TREATMENT - p. 319 172. 21 Immunology and Allergy - p. 323 173. INTRODUCTION - p. 323 174. THE UNIFIED AIRWAY - p. 323 175. THE IMMUNE RESPONSE - p. 323 176. INNATE AND ADAPTIVE IMMUNITY - p. 324 177. THE LINK BETWEEN THE INNATE AND ADAPTIVE IMMUNE SYSTEM - p. 326 178. CELLS OF THE IMMUNE SYSTEM - p. 327 179. IMMUNOGLOBULINS - p. 332 180. CYTOKINES, INTERFERONS, AND CHEMOKINES - p. 333 181. DEVELOPMENT OF ALLERGY - p. 333 182. THE NEURAL COMPONENT OF ALLERGY - p. 346 183. CONCLUSION - p. 347 184. 22 Allergy Testing - p. 355 185. INTRODUCTION - p. 355 186. ALLERGY TESTING ACCURACY - p. 355 187. SELECTING ALLERGENS FOR TESTING - p. 356 188. ALLERGY SKIN TESTING - p. 358 189. INTERPRETING ALLERGY TESTING - p. 363 190. CONCLUSIONS - p. 363 191. 23 The Role of Imaging in the Management of Sinonasal Disease - p. 366 192. INTRODUCTION - p. 366 193. INDICATIONS FOR SINUS CT AND MRI - p. 366 194. IMAGING TECHNIQUES - p. 366 195. IMAGING APPROACH - p. 369 196. CONCLUSION - p. 388 197. 24 Diagnostic Tools for Sinonasal Disease - p. 390 198. INTRODUCTION - p. 390 199. RIGID SINONASAL ENDOSCOPY - p. 390 200. RADIOLOGIC INVESTIGATIONS - p. 391 201. LABORATORY INVESTIGATIONS - p. 394 202. ALLERGY TESTING - p. 396 203. OLFACTORY TESTING - p. 398 204. NASAL AIRWAY PATENCY EVALUATION - p. 400 205. CILIARY TESTING - p. 401 206. TISSUE SAMPLING FOR PATHOLOGIC DIAGNOSIS - p. 402 207. 25 Allergic Rhinitis - p. 405 208. INTRODUCTION - p. 405 209. DEFINITION AND GENETICS - p. 405 210. BASIC IMMUNOLOGY OF ALLERGY - p. 405 211. EPIDEMIOLOGY - p. 405 212. DIAGNOSIS - p. 406 213. TREATMENT - p. 409 214. CONCLUSION - p. 412 215. 26 Nonallergic Rhinitis - p. 416 216. INTRODUCTION - p. 416 217. EPIDEMIOLOGY AND SOCIAL IMPACT - p. 416 218. PHYSIOLOGY - p. 417 219. CLASSIFICATION - p. 417 220. IDIOPATHIC RHINITIS - p. 418 221. NONALLERGIC RHINITIS WITH EOSINOPHILIA SYNDROME - p. 421 222. WORK-RELATED RHINITIS (OCCUPATIONAL RHINITIS) - p. 422 223. DRUG-INDUCED RHINITIS - p. 424 224. HORMONE-INDUCED RHINITIS - p. 429 225. Autonomic Rhinitis (Vasomotor Rhinitis)1 - p. 430 226. ATROPHIC RHINITIS - p. 430 227. SYSTEMIC CAUSES OF NONALLERGIC RHINITIS - p. 432 228. AGING AND RHINITIS - p. 433 229. 27 Systemic Diseases That Affect the Nose and Sinuses - p. 439 230. INTRODUCTION - p. 439 231. CONGENITAL/GENETIC - p. 439 232. GRANULOMATOUS - p. 441 233. AUTOIMMUNE - p. 443 234. HEMATOLOGIC - p. 447 235. OTHER - p. 449 236. 28 Epistaxis - p. 452 237. EPIDEMIOLOGY - p. 452 238. VASCULAR ANATOMY OF THE NOSE - p. 454 239. CLINICAL MANAGEMENT - p. 455 240. MANAGEMENT OF COMORBID SYSTEMIC FACTORS - p. 458 241. SURGICAL MANAGEMENT - p. 459 242. ENDOVASCULAR EMBOLIZATION - p. 461 243. 29 Acute Rhinosinusitis - p. 463 244. ABSTRACT - p. 463 245. DEFINING RHINOSINUSITIS - p. 463 246. EPIDEMIOLOGY - p. 464 247. PATHOPHYSIOLOGY AND MICROBIOLOGY - p. 465 248. CLINICAL PRESENTATION AND EVALUATION - p. 468 249. IMAGING - p. 469 250. TREATMENT - p. 471 251. COMPLICATIONS - p. 474 252. SPECIAL CONSIDERATIONS IN THE PEDIATRIC POPULATION - p. 477 253. CONCLUSION - p. 477 254. 30 Chronic Rhinosinusitis with Nasal Polyposis - p. 482 255. INTRODUCTION - p. 482 256. EPIDEMIOLOGY OF NASAL POLYP DISEASE - p. 482 257. CLINICAL PRESENTATION AND DIAGNOSIS - p. 483 258. SEVERITY CLASSIFICATION IN NASAL POLYP DISEASE - p. 486 259. HISTOPATHOLOGY - p. 486 260. PATHOPHYSIOLOGY - p. 486 261. NASAL POLYPS AND ALLERGY - p. 488 262. NASAL POLYPS AND ASTHMA - p. 488 263. ASPIRIN-EXACERBATED RESPIRATORY DISEASE - p. 489 264. NASAL POLYPS AND FUNGI - p. 489 265. CYSTIC FIBROSIS - p. 490 266. CONCLUSION - p. 490 267. 31 Chronic Nonpolypoid Rhinosinusitis: Pathogenesis, Diagnosis, Staging, and Treatment - p. 494 268. INTRODUCTION - p. 494 269. PATHOPHYSIOLOGY - p. 494 270. DIAGNOSIS - p. 499 271. STAGING - p. 502 272. DIAGNOSTIC CORRELATES - p. 502 273. TREATMENT - p. 503 274. 32 The Unified Airway - p. 509 275. INTRODUCTION - p. 509 276. ALLERGIC RHINITIS - p. 509 277. CHRONIC RHINOSINUSITIS - p. 510 278. ASTHMA - p. 510 279. OTHER UNIFIED AIRWAY CONDITIONS - p. 511 280. EVIDENCE FOR THE UNIFIED AIRWAY - p. 512 281. CONCLUSIONS - p. 515 282. 33 Fungal Rhinosinusitis - p. 518 283. FUNGAL RHINOSINUSITIS - p. 518 284. ACUTE INVASIVE FUNGAL RHINOSINUSITIS - p. 519 285. CLINICAL PRESENTATION - p. 524 286. DIAGNOSIS - p. 524 287. IMAGING - p. 524 288. TREATMENT AND PROGNOSIS - p. 525 289. PATHOLOGY - p. 526 290. TREATMENT AND PROGNOSIS - p. 526 291. CLINICAL PRESENTATION - p. 527 292. RADIOLOGY - p. 527 293. PATHOLOGY - p. 527 294. TREATMENT - p. 528 295. CLINICAL PRESENTATION - p. 528 296. DIAGNOSIS - p. 529 297. RADIOLOGY - p. 529 298. PATHOLOGY - p. 530 299. FUNGAL CULTURE - p. 531 300. THEORIES AND CONTROVERSIES SURROUNDING PATHOGENESIS - p. 531 301. TREATMENT - p. 532 302. 34 Complications of Rhinosinusitis - p. 535 303. INTRODUCTION - p. 535 304. ORBITAL COMPLICATIONS - p. 535 305. PRESEPTAL CELLULITIS - p. 537 306. ORBITAL CELLULITIS - p. 537 307. SUBPERIOSTEAL ABSCESS - p. 538 308. ORBITAL ABSCESS - p. 539 309. CAVERNOUS SINUS THROMBOSIS - p. 539 310. EVALUATION AND DIAGNOSIS - p. 539 311. INTRACRANIAL COMPLICATIONS - p. 542 312. EPIDURAL ABSCESS - p. 544 313. SUBDURAL ABSCESS - p. 544 314. INTRACEREBRAL ABSCESS - p. 545 315. VENOUS SINUS THROMBOSIS - p. 545 316. MENINGITIS - p. 545 317. MICROBIOLOGY AND TREATMENT OF INTRACRANIAL COMPLICATIONS - p. 545 318. BONY COMPLICATIONS - p. 547 319. PREVENTION OF COMPLICATIONS OF SINUSITIS - p. 547 320. 35 Medical Management of Chronic Sinusitis - p. 550 321. INTRODUCTION - p. 550 322. DEFINITION AND DIAGNOSIS - p. 550 323. STAGING SYSTEMS - p. 551 324. MEDICAL MANAGEMENT OF CHRONIC RHINOSINUSITIS - p. 551 325. CONCLUSION - p. 557 326. 36 Endoscopic Sinus Surgery for Chronic Rhinosinusitis - p. 561 327. INTRODUCTION - p. 561 328. PREPARATION FOR SURGERY - p. 561 329. SURGICAL TECHNIQUE - p. 563 330. MAXILLARY SINUS— Video 36.1 - p. 564 331. ETHMOID CAVITY— Video 36.2 - p. 565 332. ANTERIOR ETHMOIDECTOMY - p. 565 333. CONCHA BULLOSA— Video 36.3 - p. 566 334. POSTERIOR ETHMOIDECTOMY - p. 566 335. SPHENOID SINUS— Video 36.5 - p. 567 336. BALLOON SINUPLASTY - p. 568 337. REVISION SURGERY - p. 568 338. MAXILLARY SINUS - p. 569 339. ETHMOID CAVITY - p. 569 340. SPHENOID SINUS - p. 569 341. OUTCOMES OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY - p. 570 342. CONCLUSION - p. 570 343. 37 External Approaches in Sinus Surgery - p. 572 344. INTRODUCTION - p. 572 345. MAXILLARY SINUSES - p. 572 346. FRONTAL SINUSES - p. 573 347. ETHMOID SINUSES - p. 578 348. SPHENOID SINUS - p. 578 349. CONCLUSIONS - p. 579 350. 38 Septoplasty, Turbinate Reduction, and Correction of Nasal Obstruction - p. 581 351. EVALUATION AND ASSESSMENT - p. 581 352. DEVIATED NASAL SEPTUM - p. 583 353. INDICATIONS - p. 583 354. TURBINATE REDUCTION - p. 586 355. NASAL VALVE OBSTRUCTION - p. 588 356. CONCLUSION - p. 589 357. 39 Endoscopic Orbital Surgery - p. 591 358. INTRODUCTION - p. 591 359. ANATOMY - p. 591 360. EPIPHORA AND ENDOSCOPIC DACRYOCYSTORHINOSTOMY - p. 594 361. ENDOSCOPIC ORBITAL AND OPTIC NERVE DECOMPRESSION - p. 596 362. ENDOSCOPIC MANAGEMENT OF ORBITAL NEOPLASMS - p. 599 363. TRANSORBITAL NEUROENDOSCOPIC SURGERY (TONES) - p. 604 364. 40 Endoscopic Approaches to the Anterior Ventral Skull Base - p. 607 365. INTRODUCTION - p. 607 366. PATIENT SELECTION AND INDICATIONS - p. 607 367. DIAGNOSTIC WORK-UP - p. 608 368. SURGICAL ANATOMY - p. 611 369. SURGICAL TECHNIQUE - p. 611 370. POSTOPERATIVE CARE - p. 615 371. COMPLICATIONS - p. 615 372. FUTURE PERSPECTIVES - p. 616 373. CONCLUSION - p. 617 374. 41 Endoscopic Evaluation and Treatment of CSF Leaks - p. 620 375. HISTORY OF CSF LEAK SURGERY - p. 620 376. CSF PHYSIOLOGY AND INTRACRANIAL PRESSURE BASICS - p. 620 377. ETIOLOGY - p. 620 378. PATIENT WORKUP - p. 624 379. PERIOPERATIVE ISSUES - p. 625 380. SURGICAL MANAGEMENT - p. 626 381. SITE-SPECIFIC REPAIR STRATEGY - p. 627 382. RECONSTRUCTIVE TECHNIQUES - p. 628 383. POSTOPERATIVE CARE - p. 629 384. LONG-TERM MANAGEMENT - p. 629 385. OUTCOMES - p. 630 386. 42 Frontal Sinus Surgery - p. 632 387. INTRODUCTION - p. 632 388. INDICATIONS FOR FRONTAL SINUS SURGERY IN CHRONIC RHINOSINUSITIS - p. 632 389. SURGICAL ANATOMY—THE NEW INTERNATIONAL FRONTAL SINUS ANATOMY CLASSIFICATION - p. 633 390. THE BUILDING BLOCK CONCEPT FOR A 3D UNDERSTANDING OF THE FRONTAL RECESS - p. 633 391. COMPLEXITY OF THE FRONTAL RECESS ANATOMY - p. 638 392. FRONTAL SINUS SURGERY AND OUTCOMES OF THE FRONTAL DRILL-OUT/MODIFIED LOTHROP - p. 638 393. AXILLARY FLAP - p. 639 394. MINI-TREPHINATION - p. 640 395. IMAGE-GUIDED SURGERY - p. 640 396. POSTOPERATIVE CARE - p. 643 397. CONTROVERSIES IN FRONTAL SINUS SURGERY - p. 643 398. SECTION III: COMPREHENSIVE OTOLARYNGOLOGY - p. 645 399. 43 Anatomy and Physiology of the Salivary Glands - p. 647 400. INTRODUCTION - p. 647 401. EMBRYOLOGY - p. 647 402. PHYSIOLOGY OF THE SALIVARY GLAND - p. 653 403. IMAGING - p. 655 404. SIALENDOSCOPY - p. 656 405. 44 Nonneoplastic Diseases of the Salivary Glands - p. 658 406. INTRODUCTION - p. 658 407. ACUTE INFLAMMATORY LESIONS - p. 658 408. GRANULOMATOUS INFECTIONS OF THE SALIVARY GLANDS - p. 660 409. RADIATION INJURY - p. 667 410. OTHER DISORDERS - p. 669 411. COMPLICATIONS - p. 669 412. 45 Taste - p. 673 413. INTRODUCTION - p. 673 414. DEVELOPMENT OF THE TASTE SYSTEM - p. 673 415. ANATOMY OF THE TASTE SYSTEM - p. 673 416. TASTE TRANSDUCTION - p. 674 417. INNERVATION OF THE TONGUE - p. 674 418. TASTE TESTING AND BACKGROUND - p. 675 419. VIDEOMICROSCOPY (VM) - p. 676 420. TASTE ALTERING CONDITIONS - p. 676 421. EFFECTS OF TASTE LOSS - p. 678 422. THERAPY FOR TASTE LOSS - p. 678 423. CONCLUSION - p. 678 424. ACKNOWLEDGMENT - p. 678 425. 46 Stomatitis - p. 680 426. INTRODUCTION - p. 680 427. CLINICAL ASSESSMENT - p. 680 428. ETIOLOGY - p. 681 429. TREATMENT-RELATED STOMATITIS - p. 681 430. INFECTIOUS - p. 683 431. IMMUNOLOGIC - p. 687 432. SYSTEMIC CONDITIONS - p. 690 433. NUTRITIONAL - p. 692 434. IDIOPATHIC - p. 692 435. STOMATITIS UNIQUE TO CHILDHOOD - p. 696 436. MULTIFACTORIAL - p. 697 437. SUMMARY - p. 697 438. ACKNOWLEDGMENTS - p. 697 439. 47 Pharyngitis - p. 700 440. INTRODUCTION - p. 700 441. ANATOMY - p. 700 442. INFECTIOUS CAUSES OF PHARYNGITIS IN THE CHILD - p. 701 443. INFECTIOUS CAUSES OF PHARYNGITIS IN THE ADULT - p. 706 444. 48 Odontogenic Infections - p. 713 445. INTRODUCTION - p. 713 446. DEMOGRAPHICS - p. 713 447. MICROBIOLOGY - p. 713 448. SPREAD OF LOCALIZED INFECTIONS - p. 714 449. CANINE SPACE INFECTIONS - p. 716 450. BUCCAL SPACE INFECTIONS - p. 716 451. MASTICATOR SPACE INFECTIONS - p. 717 452. MANDIBULAR SPACES - p. 717 453. LUDWIG ANGINA - p. 720 454. GENERAL TREATMENT GUIDELINES - p. 721 455. COMPLICATIONS OF ODONTOGENIC INFECTIONS - p. 722 456. 49 Lymphoid Hypertrophy and Lymphadenopathy - p. 725 457. INTRODUCTION - p. 725 458. ANATOMY OF A LYMPH NODE AND LYMPHOID TISSUES - p. 725 459. OVERVIEW OF NECK LEVELS AND LYMPHATIC DRAINAGE OF THE NECK - p. 726 460. LYMPHOID HYPERTROPHY AND REACTIVE LYMPHADENOPATHY - p. 731 461. AUTOIMMUNE, METABOLIC, AND IDIOPATHIC LYMPHADENOPATHY - p. 733 462. NEOPLASTIC LYMPHADENOPATHY - p. 735 463. HIV-ASSOCIATED LYMPHADENOPATHY AND LYMPHOID HYPERTROPHY - p. 736 464. CONCLUSION - p. 736 465. 50 Headache and Facial Pain - p. 739 466. INTRODUCTION - p. 739 467. BACKGROUND - p. 739 468. DIFFERENTIAL DIAGNOSIS - p. 741 469. PATIENT EVALUATION AND WORKUP - p. 746 470. CONCLUSION - p. 747 471. 51 Diagnosis and Management of Temporomandibular Joint Spectrum Diseases - p. 749 472. INTRODUCTION - p. 749 473. ANATOMY AND PHYSIOLOGY OF THE TMJ - p. 749 474. FOCUSED HISTORY AND PHYSICAL EXAMINATION - p. 751 475. DIAGNOSTIC IMAGING OF THE TEMPOROMANDIBULAR JOINT - p. 752 476. CURRENT CLASSIFICATION SYSTEMS OF TEMPOROMANDIBULAR JOINT DISORDERS - p. 753 477. PATHOPHYSIOLOGY - p. 754 478. MANAGEMENT - p. 755 479. CONCLUSION - p. 758 480. 52 Systemic Disease Manifestations in the Head and Neck - p. 761 481. INTRODUCTION - p. 761 482. VASCULITIDES (TABLE 52.1) - p. 761 483. GRANULOMATOUS DISEASE - p. 764 484. RHEUMATOLOGIC AND AUTOIMMUNE DISEASE (TABLE 52.3) - p. 765 485. CONCLUSION - p. 772 486. 53 Soft Tissue Infections of the Head and Neck - p. 774 487. INTRODUCTION - p. 774 488. ETIOLOGY - p. 774 489. FASCIAL ORGANIZATION OF THE HEAD AND NECK - p. 774 490. DEEP NECK SPACE ANATOMY - p. 778 491. BACTERIOLOGY - p. 782 492. DIAGNOSIS - p. 782 493. MANAGEMENT - p. 784 494. COMPLICATIONS - p. 786 495. SPECIAL CONSIDERATIONS - p. 788 496. SPECIFIC DEEP NECK SPACE INFECTIONS - p. 789 497. SECTION IV: LARYNGOLOGY - p. 799 498. 54 Swallowing Anatomy and Physiology - p. 801 499. INTRODUCTION - p. 801 500. ANTICIPATORY PHASE - p. 802 501. ORAL PREPARATORY PHASE - p. 802 502. ORAL TRANSFER PHASE - p. 803 503. PHARYNGEAL PHASE - p. 804 504. ESOPHAGEAL PHASE - p. 806 505. BREATHING AND SWALLOWING COORDINATION - p. 807 506. CONCLUSION - p. 807 507. 55 Functional Assessment of Swallowing - p. 809 508. INTRODUCTION - p. 809 509. DYSPHAGIA SYMPTOM INDICES - p. 809 510. CLINICAL SWALLOW EVALUATION - p. 810 511. FLEXIBLE ENDOSCOPIC EXAMINATION OF SWALLOWING/FLEXIBLE ENDOSCOPIC EVALUATION OF SWALLOWING WITH SENSORY TESTING - p. 812 512. VIDEOFLUOROSCOPIC SWALLOW STUDY - p. 815 513. TRANSNASAL ESOPHAGOSCOPY - p. 815 514. HIGH-RESOLUTION PHARYNGEAL MANOMETRY - p. 818 515. 56 Nonsurgical Management of Swallowing Disorders - p. 823 516. INTRODUCTION - p. 823 517. COMPENSATORY TREATMENT PROCEDURES - p. 824 518. THERAPY PROCEDURES - p. 826 519. MEDICAL MANAGEMENT - p. 829 520. CONCLUSION - p. 831 521. 57 Surgical Management of Swallowing Disorders - p. 835 522. INTRODUCTION - p. 835 523. NASOPHARYNX - p. 835 524. PHARYNX/LARYNX - p. 836 525. ESOPHAGUS - p. 837 526. NEOPLASMS OF THE ESOPHAGUS - p. 841 527. ESOPHAGEAL PERFORATION - p. 842 528. TRACHEOTOMY AND DYSPHAGIA - p. 842 529. END-STAGE DYSPHAGIA - p. 842 530. 58 Esophageal Disorders: Evaluation and Management - p. 846 531. INTRODUCTION - p. 846 532. INFLAMMATORY ESOPHAGEAL DISORDERS - p. 846 533. AUTOIMMUNE ESOPHAGEAL DISORDERS - p. 850 534. MOTILITY DISORDERS - p. 850 535. STRUCTURAL DISORDERS - p. 854 536. ANATOMIC OBSTRUCTION - p. 855 537. NEOPLASTIC DISEASE - p. 857 538. ESOPHAGEAL EMERGENCIES - p. 857 539. SUMMARY - p. 858 540. 59 Upper Airway Anatomy and Function - p. 861 541. PHARYNGEAL ANATOMY - p. 861 542. PHARYNGEAL AIRWAY PHYSIOLOGY - p. 862 543. LARYNGEAL ANATOMY - p. 863 544. RESPIRATORY PHYSIOLOGY OF THE LARYNX - p. 867 545. SPEECH - p. 869 546. 60 Upper Airway Disorders: Cough and Inducible Laryngeal Obstruction - p. 872 547. INTRODUCTION - p. 872 548. CHRONIC COUGH - p. 872 549. INDUCIBLE LARYNGEAL OBSTRUCTION - p. 878 550. 61 Advanced Airway Management: Intubation - p. 888 551. HISTORY OF INTUBATION - p. 888 552. INDICATIONS FOR ENDOTRACHEAL INTUBATION - p. 888 553. CONTRAINDICATIONS FOR ENDOTRACHEAL INTUBATION - p. 888 554. AIRWAY MANAGEMENT PLANNING - p. 889 555. AIRWAY MANAGEMENT - p. 892 556. DIFFICULT AIRWAY MANAGEMENT - p. 906 557. THE COLLABORATIVE APPROACH TO SHARED AIRWAY SURGERY - p. 912 558. 62 The Surgical Airway - p. 919 559. INTRODUCTION (HISTORY) - p. 919 560. INDICATIONS FOR TRACHEOTOMY - p. 920 561. SURGICAL AIRWAY TECHNIQUES - p. 921 562. COMPLICATIONS - p. 933 563. PERCUTANEOUS DILATATIONAL TRACHEOTOMY IN THE INTENSIVE CARE UNIT - p. 936 564. TRACHEOTOMY IN THE ERA OF COVID-19: SPECIAL CONSIDERATIONS - p. 944 565. CONCLUSION - p. 945 566. 63 Upper Airway Restriction: Evaluation and Management - p. 947 567. INTRODUCTION - p. 947 568. ETIOLOGY OF OBSTRUCTION - p. 947 569. EVALUATION - p. 951 570. NONOPERATIVE MANAGEMENT - p. 953 571. SUPRAGLOTTIC STENOSIS - p. 953 572. GLOTTIC STENOSIS - p. 953 573. BILATERAL TRUE VOCAL FOLD PARALYSIS - p. 955 574. SUBGLOTTIC AND TRACHEAL STENOSIS - p. 956 575. SOLUTIONS FOR EXTENDED LENGTH TRACHEAL STENOSIS - p. 963 576. 64 Laryngeal Trauma - p. 972 577. INTRODUCTION - p. 972 578. PATHOPHYSIOLOGY OF LARYNGEAL INJURIES - p. 972 579. DIAGNOSIS AND EVALUATION - p. 973 580. MANAGEMENT - p. 975 581. COMPLICATIONS - p. 980 582. CONCLUSION - p. 982 583. 65 Voice: Anatomy, Physiology, and Clinical Evaluation - p. 984 584. INTRODUCTION - p. 984 585. ANATOMY - p. 984 586. PHYSIOLOGY - p. 990 587. EVALUATION - p. 992 588. CONCLUSION - p. 994 589. 66 Laryngopharyngeal Reflux - p. 997 590. INTRODUCTION - p. 997 591. REVIEW OF GASTRIC REFLUX CONTENTS AND PHYSIOLOGY - p. 997 592. PATHOPHYSIOLOGY OF LPR - p. 1000 593. OTHER CLINICAL MANIFESTATIONS OF EER - p. 1002 594. DIAGNOSIS - p. 1003 595. TREATMENT OF LARYNGOPHARYNGEAL REFLUX - p. 1008 596. MEDICAL TREATMENT - p. 1010 597. SURGICAL MANAGEMENT OF REFLUX - p. 1012 598. CONCLUSION - p. 1013 599. 67 Infection, Infiltration, and Benign Neoplasms of the Larynx - p. 1018 600. INTRODUCTION - p. 1018 601. INFECTIONS OF THE LARYNX - p. 1018 602. INFILTRATIVE AND INFLAMMATORY DISEASES OF THE LARYNX - p. 1021 603. BENIGN NEOPLASMS OF THE LARYNX - p. 1025 604. LARYNGOCELES AND SACCULAR CYSTS - p. 1028 605. SUMMARY - p. 1030 606. 68 Benign Vocal Fold Lesions and Phonomicrosurgery - p. 1034 607. INTRODUCTION - p. 1034 608. BENIGN EPITHELIAL LESIONS OF THE VOCAL FOLD - p. 1034 609. BENIGN LESIONS OF THE VOCAL FOLD LAMINA PROPRIA - p. 1035 610. PHONOMICROSURGERY OF THE VOCAL FOLDS - p. 1041 611. PHONOMICROSURGERY PROCEDURES, TECHNIQUES, AND METHODS - p. 1043 612. COMPLICATIONS - p. 1047 613. 69 Treatment of Unilateral Vocal Fold Paralysis and Paresis - p. 1049 614. INTRODUCTION - p. 1049 615. UNILATERAL VOCAL FOLD PARALYSIS - p. 1049 616. UNILATERAL VOCAL FOLD PARESIS - p. 1061 617. SUMMARY - p. 1065 618. 70 Neurologic Disorders of the Larynx - p. 1070 619. INTRODUCTION - p. 1070 620. NEUROANATOMY AND THE LARYNX - p. 1070 621. GENERAL APPROACH TO DIAGNOSIS AND TREATMENT - p. 1073 622. DISORDERS AFFECTING THE CENTRAL NERVOUS SYSTEM - p. 1074 623. DISORDERS AFFECTING THE PERIPHERAL NERVOUS SYSTEM - p. 1082 624. 71 Therapy for Voice Disorders - p. 1089 625. ASSESSING CANDIDACY FOR VOICE THERAPY - p. 1089 626. A FRAMEWORK FOR VOICE THERAPY - p. 1090 627. VOICE THERAPY TECHNIQUES AND PROGRAMS: THEORETICAL RATIONALE - p. 1090 628. WHEN TO DISCHARGE FROM VOICE THERAPY? - p. 1092 629. 72 Care of the Professional Voice - p. 1095 630. INTRODUCTION - p. 1095 631. HARMONIC SOUND SOURCE AND THE SOURCE FILTER THEORY OF SOUND PRODUCTION - p. 1095 632. PERFORMANCE STYLES - p. 1099 633. PATHOPHYSIOLOGY - p. 1099 634. EVALUATION OF THE PATIENT WITH VOCAL DIFFICULTIES - p. 1101 635. REFLUX - p. 1105 636. MANAGEMENT - p. 1105 637. ACUTE CARE FOR THE EMERGENT VOCAL PROBLEM - p. 1106 638. SURGICAL MANAGEMENT - p. 1107 639. CONCLUSION - p. 1107 640. 73 Special Considerations: Aging Voice, Gender Affirming Voice and Laryngeal Care, and Variants of Muscle Tension Dysphonia - p. 1110 641. AGING VOICE - p. 1110 642. GENDER AFFIRMING VOICE AND LARYNGEAL CARE - p. 1113 643. VARIANTS OF MUSCLE TENSION DYSPHONIA - p. 1117 644. ACKNOWLEDGMENT - p. 1121 645. 74 Awake Procedures in Laryngology - p. 1125 646. INTRODUCTION - p. 1125 647. LARYNGEAL VISUALIZATION - p. 1125 648. PATIENT SELECTION AND PREPARATION - p. 1125 649. ANESTHESIA - p. 1126 650. MONITORING DURING AWAKE LARYNGEAL PROCEDURES - p. 1127 651. AIRWAY EVALUATION AND ASSESSMENT - p. 1128 652. LARYNGOPHARYNGEAL BIOPSY, PANENDOSCOPY, AND TUMOR STAGING - p. 1128 653. VOCAL FOLD INJECTION - p. 1128 654. LASER PROCEDURES - p. 1133 655. SERIAL INTRALESIONAL STEROID INJECTIONS FOR SUBGLOTTIC STENOSIS - p. 1136 656. TRANSNASAL ESOPHAGOSCOPY - p. 1136 657. MISCELLANEOUS PROCEDURES - p. 1136 658. CONCLUSION - p. 1137 659. SECTION V: TRAUMA - p. 1141 660. 75 Principles of Trauma - p. 1143 661. INTRODUCTION - p. 1143 662. NEUROENDOCRINE RESPONSE - p. 1144 663. METABOLIC RESPONSE - p. 1144 664. TREATMENT OF A PATIENT WHO HAS SUSTAINED TRAUMA - p. 1144 665. ROLE OF THE OTOLARYNGOLOGIST - p. 1155 666. PRECAUTIONS IN THE COVID-19 PANDEMIC - p. 1155 667. 76 Management of Soft Tissue Injuries of the Face - p. 1158 668. INTRODUCTION - p. 1158 669. ETIOLOGY AND MECHANISM OF INJURY - p. 1158 670. EVALUATION - p. 1158 671. WOUND CLASSIFICATION - p. 1159 672. WOUND MANAGEMENT - p. 1160 673. LACERATION REPAIR - p. 1162 674. INJURIES BY ANATOMICAL LOCATION - p. 1163 675. SPECIAL CONSIDERATIONS - p. 1177 676. 77 Penetrating Face and Neck Trauma - p. 1183 677. INTRODUCTION - p. 1183 678. GENERAL TRAUMA PRINCIPLES - p. 1183 679. PENETRATING FACIAL INJURIES - p. 1185 680. PENETRATING NECK INJURIES - p. 1188 681. PEDIATRIC PENETRATING INJURIES - p. 1193 682. 78 Principles in Rigid Fixation of the Facial Skeleton - p. 1195 683. INTRODUCTION - p. 1195 684. BONE HEALING - p. 1195 685. FRACTURE PATHOPHYSIOLOGY AND CLASSIFICATION - p. 1196 686. RATIONALE FOR RIGID FIXATION - p. 1197 687. BASIC PRINCIPLES OF RIGID FIXATION - p. 1197 688. FIXATION DEVICE CLASSIFICATION AND TERMINOLOGY - p. 1198 689. PRINCIPLES OF SCREW APPLICATION - p. 1198 690. LAG SCREW APPLICATION - p. 1199 691. PLATE APPLICATION - p. 1200 692. INSTRUMENTATION - p. 1201 693. FRACTURE REDUCTION - p. 1201 694. OCCLUSION - p. 1202 695. INCISIONS AND EXPOSURE - p. 1203 696. APPROACH TO PANFACIAL FRACTURES - p. 1204 697. SOFT TISSUE LOSS - p. 1210 698. COMPLICATIONS AND REVISIONS - p. 1210 699. 79 Surgical Approaches to the Craniofacial Skeleton - p. 1213 700. INTRODUCTION - p. 1213 701. UPPER ONE-THIRD—CRANIOFACIAL SKELETON - p. 1213 702. MIDFACIAL EXPOSURES - p. 1223 703. LOWER ONE-THIRD EXPOSURE—MANDIBLE - p. 1223 704. 80 Mandibular and Dental Fractures - p. 1229 705. INTRODUCTION - p. 1229 706. ANATOMY - p. 1229 707. BIOMECHANICS OF THE MANDIBLE - p. 1230 708. EVALUATION AND DIAGNOSIS - p. 1231 709. MANAGEMENT OF DENTAL FRACTURES - p. 1234 710. MANAGEMENT OF MANDIBLE FRACTURES - p. 1236 711. SPECIAL CONSIDERATIONS - p. 1239 712. COMPLICATIONS - p. 1242 713. INFECTED MANDIBLE FRACTURES - p. 1243 714. EMERGENCIES - p. 1243 715. FUTURE CONSIDERATIONS - p. 1243 716. 81 Midface Fractures - p. 1246 717. INTRODUCTION - p. 1246 718. MIDFACE ANATOMY - p. 1246 719. CLASSIFICATION OF MIDFACE FRACTURES - p. 1248 720. EPIDEMIOLOGY - p. 1250 721. PATIENT EVALUATION - p. 1250 722. COMPUTED TOMOGRAPHY - p. 1251 723. FRACTURE MANAGEMENT: BASIC PRINCIPLES - p. 1252 724. FRACTURE MANAGEMENT: SURGICAL TECHNIQUES - p. 1253 725. COMPLEX MIDFACE TRAUMA - p. 1259 726. TECHNICAL ADJUVANTS - p. 1259 727. POSTOPERATIVE CARE - p. 1261 728. COMPLICATIONS AND SEQUELAE - p. 1261 729. 82 Orbital and Naso-orbital-ethmoid Fractures - p. 1265 730. OVERVIEW - p. 1265 731. ANATOMY - p. 1265 732. DEMOGRAPHICS AND ETIOLOGY - p. 1267 733. EVALUATION - p. 1270 734. INDICATIONS FOR AND TIMING OF SURGICAL MANAGEMENT - p. 1272 735. SURGICAL TECHNIQUES - p. 1273 736. POSTOPERATIVE CARE - p. 1280 737. COMPLICATIONS - p. 1280 738. 83 Nasal Fractures - p. 1284 739. INTRODUCTION - p. 1284 740. ANATOMY - p. 1284 741. PATHOPHYSIOLOGY—MECHANISM OF INJURY - p. 1285 742. DIAGNOSTIC ASSESSMENT - p. 1288 743. MANAGEMENT - p. 1290 744. NASAL FRACTURES IN CHILDREN - p. 1294 745. SURGICAL TECHNIQUE - p. 1295 746. COMPLICATIONS - p. 1296 747. 84 Frontal Sinus Fractures - p. 1299 748. BACKGROUND - p. 1299 749. ANATOMY - p. 1299 750. EPIDEMIOLOGY - p. 1299 751. DIAGNOSIS - p. 1299 752. TREATMENT ALGORITHM - p. 1302 753. SURGICAL APPROACHES - p. 1306 754. TREATMENT STRATEGIES - p. 1313 755. COMPLICATIONS - p. 1323 756. SUMMARY - p. 1323 757. SECTION VI: PEDIATRIC OTOLARYNGOLOGY - p. 1327 758. 85 Developmental Considerations in Pediatric Otolaryngology - p. 1329 759. PATTERNS OF GROWTH AND DEVELOPMENT - p. 1329 760. SPEECH AND LANGUAGE DEVELOPMENT - p. 1336 761. AUTISM SPECTRUM DISORDER - p. 1338 762. CARE FOR THE PEDIATRIC PATIENT - p. 1339 763. CONCLUSION - p. 1340 764. ACKNOWLEDGEMENT - p. 1341 765. 86 Laryngeal Anomalies and Laryngotracheal Clefts - p. 1342 766. INTRODUCTION - p. 1342 767. EMBRYOLOGY - p. 1342 768. ANATOMY AND PHYSIOLOGY OF THE LARYNX - p. 1342 769. DIAGNOSIS - p. 1344 770. CONGENITAL LARYNGEAL ANOMALIES - p. 1347 771. CONCLUSION - p. 1355 772. 87 Congenital Anomalies of the Nose - p. 1358 773. INTRODUCTION - p. 1358 774. EMBRYOLOGY - p. 1358 775. CLINICAL AND PATHOLOGIC FEATURES - p. 1360 776. EVALUATION - p. 1363 777. SURGICAL TREATMENT - p. 1363 778. CONCLUSION - p. 1366 779. ACKNOWLEDGMENTS - p. 1366 780. 88 Tracheal and Bronchial Disorders in Children - p. 1367 781. INTRODUCTION - p. 1367 782. EMBRYOLOGY - p. 1367 783. ANATOMY AND PHYSIOLOGY - p. 1367 784. TRACHEOBRONCHOMALACIA - p. 1368 785. TRACHEOESOPHAGEAL FISTULA - p. 1372 786. LARYNGOTRACHEAL CLEFTS - p. 1373 787. TRACHEAL STENOSIS - p. 1373 788. COMPLETE TRACHEAL RINGS - p. 1374 789. TRACHEAL SLEEVE - p. 1375 790. TRACHEAL AGENESIS - p. 1376 791. TRACHEAL BRONCHUS AND ACCESSORY CARDIAC BRONCHUS - p. 1376 792. TRACHEAL DIVERTICULA AND POUCHES - p. 1377 793. ACQUIRED TRACHEAL STENOSIS - p. 1377 794. INHALATIONAL THERMAL INJURY - p. 1379 795. TRACHEOBRONCHIAL TRAUMA - p. 1380 796. TRACHEOBRONCHIAL NEOPLASMS - p. 1380 797. FRONTIERS OF TRACHEOBRONCHIAL SURGERY - p. 1381 798. CONCLUSION - p. 1381 799. 89 Neonatal Respiratory Distress - p. 1384 800. INTRODUCTION - p. 1384 801. ANATOMY AND PHYSIOLOGY - p. 1384 802. EVALUATION - p. 1384 803. EMERGENCY AIRWAY MANAGEMENT - p. 1386 804. NASAL OBSTRUCTION - p. 1387 805. ORAL CAVITY, OROPHARYNX, HYPOPHARYNX OBSTRUCTION - p. 1388 806. LARYNGEAL OBSTRUCTION - p. 1389 807. TRACHEAL AND BRONCHIAL OBSTRUCTION - p. 1391 808. CONGENITAL HIGH AIRWAY OBSTRUCTION - p. 1392 809. PRENATAL FETAL ASSESSMENT - p. 1392 810. EXIT PROCEDURE - p. 1393 811. CONCLUSION - p. 1393 812. 90 Ankyloglossia and Other Oral Frenula - p. 1396 813. INTRODUCTION - p. 1396 814. ANKYLOGLOSSIA - p. 1396 815. MAXILLARY LABIAL FRENULUM - p. 1402 816. BUCCAL FRENULA - p. 1404 817. CONTROVERSY - p. 1404 818. CONTRIBUTORS TO INCREASED FRENOTOMY RATES - p. 1405 819. CONCLUSION - p. 1405 820. 91 Pediatric Oromotor Feeding Disorders and Aversion - p. 1410 821. INTRODUCTION - p. 1410 822. EPIDEMIOLOGY - p. 1410 823. TYPICAL ORAL MOTOR/FEEDING SKILL DEVELOPMENT - p. 1411 824. CAUSES AND CLINICAL PRESENTATION OF PEDIATRIC OROMOTOR DISORDERS AND ORAL/FOOD AVERSION - p. 1411 825. ASSESSMENT AND MANAGEMENT OF OROMOTOR DISORDERS AND AVERSION - p. 1420 826. CONCLUSION - p. 1421 827. 92 Evaluation and Management of Pediatric Stridor - p. 1423 828. INTRODUCTION - p. 1423 829. PHYSIOLOGY OF STRIDOR - p. 1423 830. STRIDOR: PHASES AND LOCATION - p. 1423 831. HISTORY - p. 1425 832. PHYSICAL EXAMINATION - p. 1426 833. CASE PRESENTATIONS - p. 1428 834. CONCLUSION - p. 1431 835. ACKNOWLEDGMENTS - p. 1431 836. 93 Cough in Children - p. 1435 837. INTRODUCTION - p. 1435 838. HISTORY AND PHYSICAL EXAMINATION - p. 1435 839. DIAGNOSTIC TESTS - p. 1436 840. ENDOSCOPY - p. 1436 841. DIFFERENTIAL DIAGNOSIS - p. 1437 842. COUGH TREATMENT - p. 1439 843. CONCLUSION - p. 1440 844. 94 Pharyngeal Dysphagia and Aspiration in Children - p. 1442 845. INTRODUCTION - p. 1442 846. NORMAL AND ABNORMAL SWALLOWING PHYSIOLOGY - p. 1442 847. ETIOLOGY OF PHARYNGEAL DYSPHAGIA - p. 1443 848. EVALUATION AND MANAGEMENT OF THE CHILD WITH PHARYNGEAL DYSPHAGIA AND ASPIRATION - p. 1448 849. CONCLUSION - p. 1451 850. 95 Laryngeal Stenosis and Airway Reconstruction - p. 1455 851. INTRODUCTION - p. 1455 852. AGE-RELATED ANATOMIC DIFFERENCES IN THE LARYNX - p. 1455 853. LARYNGEAL STENOSIS - p. 1456 854. TRACHEAL STENOSIS - p. 1460 855. DIFFERENTIAL DIAGNOSIS - p. 1461 856. MANAGEMENT - p. 1461 857. DECISION-MAKING - p. 1469 858. COMPLICATIONS - p. 1470 859. EMERGENCIES - p. 1470 860. LONG-TERM MANAGEMENT - p. 1470 861. CONCLUSION - p. 1470 862. ACKNOWLEDGMENT - p. 1471 863. 96 Pediatric Voice - p. 1473 864. BACKGROUND AND EPIDEMIOLOGY - p. 1473 865. ANATOMY AND FUNCTION OF PEDIATRIC LARYNX - p. 1473 866. EVALUATION AND DIAGNOSTIC TOOLS IN PEDIATRIC VOICE - p. 1473 867. ETIOLOGIES OF PEDIATRIC DYSPHONIA - p. 1475 868. CONCLUSION - p. 1482 869. ACKNOWLEDGMENT - p. 1482 870. 97 Pediatric Tracheotomy - p. 1486 871. INTRODUCTION - p. 1486 872. INDICATIONS FOR TRACHEOTOMY - p. 1487 873. TRACHEOTOMY VERSUS ENDOTRACHEAL INTUBATION - p. 1488 874. TRACHEOTOMY TECHNIQUE - p. 1490 875. POSTOPERATIVE CARE - p. 1495 876. COMPLICATIONS OF TRACHEOTOMY - p. 1496 877. QUALITY IMPROVEMENT INITIATIVES - p. 1500 878. TRACHEOSTOMY TUBES - p. 1500 879. DECANNULATION - p. 1501 880. TRACHEOCUTANEOUS FISTULA - p. 1502 881. COMMUNICATION CONCERNS - p. 1502 882. SWALLOWING - p. 1503 883. CONCLUSION - p. 1503 884. 98 Ingestion Injuries and Foreign Bodies of the Aerodigestive Tract - p. 1507 885. INTRODUCTION - p. 1507 886. CHEMICAL HAZARDS - p. 1507 887. CLINICAL PRESENTATION - p. 1509 888. DIAGNOSIS - p. 1510 889. FOREIGN BODY INGESTION - p. 1512 890. FOREIGN BODY ASPIRATION - p. 1518 891. ACKNOWLEDGMENT - p. 1521 892. 99 Recurrent Respiratory Papillomatosis - p. 1523 893. INTRODUCTION - p. 1523 894. ETIOLOGY - p. 1524 895. EPIDEMIOLOGY - p. 1526 896. CLINICAL FEATURES - p. 1528 897. PATIENT ASSESSMENT - p. 1528 898. OTHER CONSIDERATIONS - p. 1530 899. SURGICAL MANAGEMENT - p. 1530 900. SPECIAL CONSIDERATIONS - p. 1531 901. RECURRENT RESPIRATORY PAPILLOMATOSIS STAGING - p. 1535 902. MEDICAL MANAGEMENT - p. 1538 903. ADJUVANT THERAPIES - p. 1538 904. CONCLUSION - p. 1541 905. 100 Adenotonsillar Disease in Children - p. 1545 906. INTRODUCTION - p. 1545 907. EPIDEMIOLOGY - p. 1545 908. EMBRYOLOGY - p. 1545 909. ANATOMY - p. 1546 910. IMMUNOPHYSIOLOGY - p. 1547 911. CLINICAL PRESENTATION - p. 1547 912. CLINICAL EVALUATION - p. 1549 913. MANAGEMENT - p. 1550 914. SURGICAL TECHNIQUES - p. 1552 915. OUTCOMES - p. 1553 916. CONTRAINDICATIONS - p. 1555 917. COMPLICATIONS - p. 1555 918. PERITONSILLAR ABSCESS - p. 1556 919. CONTROVERSIES - p. 1556 920. CLINICAL PRACTICE GUIDELINES - p. 1558 921. NEOPLASIA - p. 1558 922. CONCLUSION - p. 1559 923. ACKNOWLEDGMENT - p. 1559 924. 101 Diagnosis and Initial Management of Pediatric Sleep Disorders - p. 1562 925. INTRODUCTION - p. 1562 926. EPIDEMIOLOGY - p. 1562 927. PATHOPHYSIOLOGY - p. 1562 928. DIAGNOSTIC EVALUATION - p. 1563 929. TREATMENT OF OSA - p. 1567 930. MANAGING RESIDUAL OSA S/P ADENOTONSILLECTOMY - p. 1568 931. OTHER CONSIDERATIONS FOR TREATMENT OF PERSISTENT OSA - p. 1571 932. CONCLUSION - p. 1571 933. 102 Surgical Management of Pediatric Sleep Disordered Breathing - p. 1575 934. INTRODUCTION - p. 1575 935. SURGICAL TREATMENT OF OSA - p. 1576 936. PRE-, PERI-, AND POSTOPERATIVE MANAGEMENT - p. 1577 937. PERSISTENT OSA AFTER TONSILLECTOMY AND ADENOIDECTOMY - p. 1578 938. TREATMENT OF PERSISTENT OSA AFTER T&A IN CHILDREN - p. 1582 939. CONCLUSION - p. 1589 940. 103 Velopharyngeal Dysfunction - p. 1594 941. INTRODUCTION - p. 1594 942. DEFINING VELOPHARYNGEAL DYSFUNCTION - p. 1594 943. COMMON MISNOMERS - p. 1595 944. CAUSES OF VELOPHARYNGEAL INSUFFICIENCY - p. 1595 945. ASSESSMENT OF PATIENTS WITH VPD - p. 1596 946. MANAGEMENT - p. 1598 947. CONCLUSION - p. 1604 948. 104 Pediatric Rhinosinusitis: Acute and Chronic - p. 1607 949. INTRODUCTION - p. 1607 950. ANATOMY AND PATHOPHYSIOLOGY - p. 1607 951. ACUTE BACTERIAL SINUSITIS - p. 1607 952. CHRONIC RHINOSINUSITIS - p. 1609 953. COMPLICATIONS - p. 1613 954. SPECIAL POPULATIONS - p. 1615 955. ACKNOWLEDGMENTS - p. 1616 956. 105 Pediatric Allergy and Immunology - p. 1619 957. INTRODUCTION - p. 1619 958. ALLERGIC RHINITIS - p. 1619 959. FOOD ALLERGY - p. 1623 960. PEDIATRIC IMMUNOLOGY - p. 1626 961. 106 Pediatric Skull Base Lesions - p. 1631 962. INTRODUCTION - p. 1631 963. CONGENITAL PEDIATRIC SKULL BASE LESIONS - p. 1631 964. NEOPLASTIC SKULL BASE LESIONS: BENIGN - p. 1632 965. NEOPLASTIC SKULL BASE LESIONS: MALIGNANT - p. 1636 966. SKULL BASE FIBRO-OSSEOUS LESIONS - p. 1637 967. SURGICAL APPROACHES TO THE ANTERIOR PEDIATRIC SKULL BASE - p. 1640 968. SURGICAL APPROACHES TO MIDDLE CRANIAL FOSSA - p. 1640 969. SURGICAL APPROACHES TO POSTERIOR CRANIAL FOSSA - p. 1641 970. PEDIATRIC SKULL BASE RECONSTRUCTION - p. 1641 971. CONCLUSION - p. 1642 972. 107 Pediatric Salivary Gland Disorders - p. 1645 973. INTRODUCTION - p. 1645 974. INFLAMMATORY CONDITIONS - p. 1645 975. SALIVARY GLAND NEOPLASMS - p. 1647 976. EPITHELIAL NEOPLASMS - p. 1648 977. OTHER DISORDERS - p. 1652 978. ACKNOWLEDGEMENT - p. 1659 979. 108 Acute and Chronic Pediatric Otitis Media - p. 1662 980. INTRODUCTION - p. 1662 981. DEFINITIONS/SIGNS AND SYMPTOMS - p. 1662 982. EPIDEMIOLOGY - p. 1662 983. PATHOPHYSIOLOGY - p. 1663 984. RISK FACTORS - p. 1665 985. DIAGNOSIS - p. 1665 986. TREATMENT - p. 1667 987. COMPLICATIONS OF AOM AND OME - p. 1670 988. FUTURE TRENDS TO FOLLOW - p. 1670 989. ACKNOWLEDGEMENTS - p. 1671 990. 109 Newborn and Pediatric Hearing Screening and Amplification - p. 1674 991. INTRODUCTION - p. 1674 992. NEWBORN HEARING SCREENING - p. 1674 993. DIAGNOSTIC TESTING BATTERY - p. 1681 994. NONSURGICAL REHABILITATION - p. 1685 995. CONCLUSION - p. 1687 996. ACKNOWLEDGEMENT - p. 1687 997. 110 Aural Implantation and Rehabilitation in Children - p. 1690 998. INTRODUCTION - p. 1690 999. COCHLEAR IMPLANTATION IN CHILDREN - p. 1691 1000. BONE CONDUCTION IMPLANTS IN CHILDREN - p. 1705 1001. ACKNOWLEDGMENT - p. 1712 1002. 111 Genetic and Nongenetic Sources of Hearing Loss in Children - p. 1720 1003. INTRODUCTION - p. 1720 1004. OVERVIEW OF CAUSES OF HEARING LOSS IN CHILDREN - p. 1721 1005. GENETIC HEARING LOSS IN CHILDREN - p. 1721 1006. NONGENETIC HEARING LOSS IN CHILDREN - p. 1729 1007. STRUCTURAL ANOMALIES CAUSING HEARING LOSS IN CHILDREN - p. 1733 1008. DIAGNOSTIC EVALUATION FOR CHILDREN WITH HEARING LOSS - p. 1736 1009. CONCLUSION - p. 1738 1010. 112 Congenital Aural Atresia and Acquired External Auditory Canal Stenosis - p. 1741 1011. CONGENITAL MALFORMATION OF THE EAR - p. 1741 1012. ACQUIRED ATRESIA OF THE EXTERNAL AUDITORY CANAL - p. 1754 1013. CONCLUSION - p. 1756 1014. 113 Management of Cleft Lip and Palate - p. 1760 1015. INTRODUCTION - p. 1760 1016. EPIDEMIOLOGY - p. 1760 1017. EMBRYOLOGY - p. 1761 1018. PRENATAL DIAGNOSIS AND COUNSELING - p. 1762 1019. FEEDING - p. 1763 1020. CLEFT LIP REPAIR - p. 1763 1021. CLEFT PALATE REPAIR - p. 1769 1022. CONCLUSION - p. 1776 1023. 114 Vascular Anomalies of the Head and Neck - p. 1779 1024. INTRODUCTION - p. 1779 1025. VASCULAR TUMORS - p. 1779 1026. VASCULAR MALFORMATIONS - p. 1788 1027. GENETICS OF VASCULAR ANOMALIES - p. 1794 1028. 115 Pediatric Head and Neck Tumors - p. 1797 1029. INTRODUCTION - p. 1797 1030. DIAGNOSTIC APPROACH - p. 1797 1031. RHABDOMYOSARCOMAS - p. 1798 1032. NONRHABDOMYOSARCOMA SOFT TISSUE SARCOMAS - p. 1801 1033. EWING SARCOMA FAMILY OF TUMORS - p. 1803 1034. MAXILLARY AND MANDIBULAR TUMORS - p. 1804 1035. SALIVARY GLAND MALIGNANCY - p. 1806 1036. NASOPHARYNGEAL CARCINOMA - p. 1808 1037. MELANOMA - p. 1809 1038. CONCLUSION - p. 1810 1039. 116 Pediatric Thyroid Disease - p. 1814 1040. INTRODUCTION - p. 1814 1041. ANATOMY AND EMBRYOLOGY - p. 1814 1042. BENIGN PEDIATRIC THYROID DISEASE - p. 1815 1043. PEDIATRIC THYROID MALIGNANCIES - p. 1817 1044. PEDIATRIC THYROID NODULE EVALUATION - p. 1819 1045. THYROID SURGERY - p. 1820 1046. POSTOPERATIVE THYROID CANCER CONSIDERATIONS - p. 1825 1047. CONCLUSION - p. 1827 1048. 117 Congenital Cysts, Sinuses, and Infections of the Head and Neck - p. 1830 1049. INTRODUCTION - p. 1830 1050. BRANCHIAL APPARATUS ANOMALIES - p. 1830 1051. PREAURICULAR CYSTS AND SINUSES - p. 1834 1052. THYROGLOSSAL DUCT ANOMALIES - p. 1835 1053. DERMOID CYSTS - p. 1837 1054. ACKNOWLEDGMENT - p. 1838 1055. 118 Relevant Syndromes in Pediatric Otolaryngology - p. 1840 1056. INTRODUCTION - p. 1840 1057. GENETICS OVERVIEW - p. 1840 1058. A PRACTICAL APPROACH TO THE INFANT OR CHILD WHO IS SYNDROMIC - p. 1844 1059. APERT SYNDROME - p. 1844 1060. BRANCHIOOTORENAL SYNDROME - p. 1846 1061. CHARGE ASSOCIATION - p. 1847 1062. CROUZON SYNDROME - p. 1849 1063. DOWN SYNDROME - p. 1849 1064. GOLDENHAR SYNDROME - p. 1850 1065. KARTAGENER SYNDROME - p. 1852 1066. MELKERSSON-ROSENTHAL SYNDROME - p. 1853 1067. NEUROFIBROMATOSIS 1 - p. 1853 1068. NEUROFIBROMATOSIS 2 - p. 1853 1069. PIERRE ROBIN SEQUENCE - p. 1854 1070. VELOCARDIOFACIAL SYNDROME/DIGEORGE SYNDROME/SHPRINTZEN SYNDROME - p. 1855 1071. TREACHER COLLINS SYNDROME - p. 1856 1072. USHER SYNDROME - p. 1857 1073. WAARDENBURG SYNDROME - p. 1857 1074. PENDRED SYNDROME - p. 1858 1075. FETAL ALCOHOL SYNDROME - p. 1858 1076. MANIFESTATIONS OF OTHER SYNDROMES AND CONDITIONS - p. 1859 1077. ACKNOWLEDGMENT - p. 1865 1078. 119 Anesthesia Considerations for Pediatric Otolaryngology - p. 1869 1079. INTRODUCTION - p. 1869 1080. PREOPERATIVE CONSIDERATIONS - p. 1869 1081. INTRAOPERATIVE MANAGEMENT - p. 1879 1082. POSTOPERATIVE CONSIDERATIONS - p. 1883 1083. ANESTHETIC CONSIDERATIONS FOR SPECIFIC OTORHINOLARYNGOLOGIC PROCEDURES - p. 1885 1084. CONCLUSION - p. 1889 1085. 120 Pediatric Facial Trauma - p. 1894 1086. EPIDEMIOLOGY - p. 1894 1087. SPECIAL CONSIDERATIONS IN PEDIATRIC FACIAL TRAUMA - p. 1894 1088. SOFT TISSUE INJURIES - p. 1895 1089. NASAL FRACTURES - p. 1896 1090. MANDIBLE FRACTURES - p. 1898 1091. MIDFACE FRACTURES - p. 1900 1092. ORBITAL AND FRONTAL SINUS FRACTURES - p. 1901 1093. NASOORBITOETHMOID FRACTURES - p. 1903 1094. FRACTURE FIXATION AND PLATING SYSTEMS - p. 1904 1095. CONCLUSION - p. 1905 1096. 121 Infections of the Pediatric Upper and Lower Airway - p. 1908 1097. INTRODUCTION - p. 1908 1098. NASAL SEPTAL ABSCESS - p. 1908 1099. PEDIATRIC RHINOSINUSITIS - p. 1910 1100. DEEP NECK SPACE INFECTIONS - p. 1912 1101. PARAPHARYNGEAL AND RETROPHARYNGEAL ABSCESS - p. 1914 1102. MEDIASTINITIS AND THROMBOPHLEBITIS - p. 1915 1103. ADENOTONSILLAR INFECTIONS - p. 1916 1104. TONSILLITIS - p. 1917 1105. PERITONSILLAR ABSCESS - p. 1918 1106. EPIGLOTTITIS - p. 1918 1107. CROUP (LARYNGOTRACHEITIS) - p. 1919 1108. BRONCHIOLITIS - p. 1920 1109. PNEUMONIA - p. 1920 1110. 122 Surgical Management of Craniofacial Disorders - p. 1925 1111. INTRODUCTION - p. 1925 1112. ANATOMY AND DEVELOPMENT OF THE CRANIOFACIAL SKELETON - p. 1925 1113. SYNDROMES ASSOCIATED WITH CRANIOFACIAL DISORDERS - p. 1926 1114. MANDIBULAR HYPOPLASIA - p. 1928 1115. CRANIOSYNOSTOSIS - p. 1930 1116. MAXILLARY DISTRACTION - p. 1934 1117. MIDFACE SURGERY - p. 1934 1118. CONCLUSION - p. 1936 1119. 123 Management of Reflux and Eosinophilic Esophagitis - p. 1938 1120. INTRODUCTION - p. 1938 1121. GASTROESOPHAGEAL REFLUX AND GASTROESOPHAGEAL REFLUX DISEASE - p. 1938 1122. EOSINOPHILIC ESOPHAGITIS - p. 1941 1123. CONCLUSION - p. 1945 1124. VOLUME TWO - p. 1949 1125. SECTION VII: HEAD AND NECK SURGERY - p. 1949 1126. 124 Head and Neck Tumor Biology - p. 1951 1127. INTRODUCTION - p. 1951 1128. DIFFERENT SUBTYPES OF HNSCC IDENTIFIED BASED ON RISK FACTORS AND GENETICS - p. 1951 1129. PATHOGENESIS AND FIELD CANCERIZATION - p. 1953 1130. Upstream of the Cell Cycle: Epidermal Growth Factor Receptor and Tgfβ - p. 1955 1131. CELL CYCLE REGULATION - p. 1958 1132. CELL CYCLE REGULATORS: A CHECK ON PROLIFERATION - p. 1961 1133. DNA REPAIR PATHWAYS MAINTAIN GENOME INTEGRITY - p. 1963 1134. APOPTOSIS IS DISRUPTED IN CANCER - p. 1967 1135. CANCER STEM CELLS CONTRIBUTE TO TUMOR HETEROGENEITY - p. 1969 1136. TUMOR MICROENVIRONMENT MODULATES TUMOR GROWTH - p. 1970 1137. ANGIOGENESIS AND VASCULOGENESIS FEED TUMOR GROWTH - p. 1971 1138. IMMUNE RESPONSE IMPACTS TUMOR GROWTH - p. 1972 1139. CONCLUSION - p. 1973 1140. 125 Tumor Immunology and Immunotherapy - p. 1980 1141. BASIC PRINCIPLES OF TUMOR IMMUNOLOGY - p. 1980 1142. IMMUNE ESCAPE IN HEAD AND NECK CANCER - p. 1982 1143. IMMUNOTHERAPEUTIC STRATEGIES FOR TREATMENT OF HEAD AND NECK CANCER - p. 1984 1144. 126 Principles of Multidisciplinary Treatment in Head and Neck Cancer - p. 1995 1145. DEFINITION OF MULTIDISCIPLINARY CARE - p. 1995 1146. OVERALL IMPACT OF MULTIDISCIPLINARY TEAMS - p. 1996 1147. CENTRALIZATION OF SERVICES, CARE PATHWAYS, AND QUALITY INDICATORS - p. 1996 1148. MULTIDISCIPLINARY CARE AND QUALITY OF LIFE METRICS - p. 1997 1149. SURVIVAL IMPACT OF MULTIDISCIPLINARY TEAMS - p. 1998 1150. PATTERNS OF MULTIDISCIPLINARY CARE - p. 1998 1151. TELEMEDICINE AND VIRTUAL MULTIDISCIPLINARY CARE - p. 1998 1152. 127 Principles of Head and Neck Radiation Oncology - p. 2001 1153. RADIATION BIOLOGY - p. 2001 1154. RADIATION DOSE MEASUREMENTS AND RADIATION SAFETY - p. 2002 1155. RADIATION DOSE AND FRACTIONATION - p. 2003 1156. 128 Chemotherapy and Targeted Therapy in Head and Neck Cancer - p. 2014 1157. INTRODUCTION - p. 2014 1158. HNSCC BIOLOGY AND SENSITIVITY/RESISTANCE TO SYSTEMIC THERAPY - p. 2015 1159. SYSTEMIC THERAPY IN HEAD AND NECK SQUAMOUS CELL CARCINOMA - p. 2017 1160. CHEMOTHERAPY DRUGS USED TO TREAT HEAD AND NECK CANCER - p. 2023 1161. TARGETED THERAPY - p. 2024 1162. CLINICAL TRIALS - p. 2024 1163. 129 Salvage Surgery in Head and Neck Cancer - p. 2029 1164. INTRODUCTION - p. 2029 1165. EFFECTS OF RADIATION (AND CHEMOTHERAPY) ON TISSUE - p. 2029 1166. CONSIDERATIONS PRIOR TO SALVAGE SURGERY - p. 2030 1167. RECONSTRUCTIVE SURGERY IN THE HEAD NECK - p. 2031 1168. SALVAGE SURGERY BY ANATOMIC SITE - p. 2031 1169. NASOPHARYNX - p. 2033 1170. ORAL CAVITY - p. 2034 1171. OROPHARYNX - p. 2035 1172. LARYNGEAL CANCER - p. 2037 1173. SALVAGE SURGERY IN MAJOR SALIVARY GLANDS - p. 2038 1174. SURGERY FOR RECURRENT CUTANEOUS MALIGNANCY - p. 2040 1175. SALVAGE NECK DISSECTION AND CAROTID MANAGEMENT - p. 2040 1176. 130 Nonmelanoma Skin Cancer - p. 2044 1177. OVERVIEW AND EPIDEMIOLOGY - p. 2044 1178. RISK FACTORS - p. 2044 1179. WORKUP OF NONMELANOMA SKIN CANCERS - p. 2045 1180. BASAL CELL CARCINOMA - p. 2045 1181. CUTANEOUS SQUAMOUS CELL CARCINOMA - p. 2050 1182. MERKEL CELL CARCINOMA - p. 2054 1183. FOLLOW-UP AND PREVENTION - p. 2055 1184. 131 Malignant Melanoma of the Head and Neck Region - p. 2058 1185. INTRODUCTION - p. 2058 1186. EPIDEMIOLOGY - p. 2058 1187. CLINICAL PRESENTATION AND DIAGNOSIS - p. 2058 1188. PATHOLOGY - p. 2059 1189. MELANOMA SUBTYPES - p. 2059 1190. MUCOSAL MELANOMA - p. 2061 1191. MELANOMA STAGING SYSTEM - p. 2062 1192. TREATMENT - p. 2064 1193. NODAL EVALUATION - p. 2065 1194. SYSTEMIC THERAPY - p. 2070 1195. SURVEILLANCE - p. 2073 1196. CONCLUSION - p. 2073 1197. 132 Salivary Gland Neoplasms - p. 2079 1198. EPIDEMIOLOGY - p. 2079 1199. ANATOMY, ETIOLOGY, AND PATHOPHYSIOLOGY - p. 2079 1200. EVALUATION - p. 2080 1201. INVESTIGATIONS - p. 2080 1202. BENIGN SALIVARY NEOPLASMS - p. 2082 1203. MALIGNANT SALIVARY NEOPLASMS - p. 2084 1204. TREATMENT - p. 2086 1205. ADJUVANT TREATMENTS - p. 2089 1206. COMPLICATIONS OF TREATMENT - p. 2089 1207. 133 Lip Cancer and Reconstruction - p. 2092 1208. FUNCTIONAL ANATOMY - p. 2092 1209. BIOLOGICAL BEHAVIOR - p. 2093 1210. CLINICAL EVALUATION - p. 2095 1211. MANAGEMENT - p. 2095 1212. LIP RECONSTRUCTION - p. 2097 1213. NEAR-TOTAL TO TOTAL CIRCUMFERENTIAL DEFECTS OF THE LIP - p. 2108 1214. COMPLICATIONS - p. 2109 1215. EMERGENCIES - p. 2109 1216. 134 Neck Dissection: Anatomy, Workup, and Indications for Oncologic Treatment - p. 2113 1217. ANATOMY - p. 2113 1218. DIAGNOSTIC EVALUATION - p. 2117 1219. STAGING - p. 2121 1220. CLASSIFICATION OF DIFFERENT NECK DISSECTIONS - p. 2122 1221. CURRENT CONTROVERSIES - p. 2126 1222. CONTRAINDICATIONS - p. 2127 1223. COMPLICATIONS - p. 2127 1224. CONTRAINDICATIONS - p. 2129 1225. 135 Nasopharyngeal Carcinoma - p. 2133 1226. INTRODUCTION - p. 2133 1227. HISTOPATHOLOGY - p. 2134 1228. CLINICAL PRESENTATIONS - p. 2134 1229. SCREENING - p. 2136 1230. DIAGNOSIS - p. 2136 1231. SEROLOGY AND LIQUID BIOPSY - p. 2136 1232. ENDOSCOPIC EXAMINATION - p. 2137 1233. IMAGING STUDIES - p. 2137 1234. STAGING - p. 2141 1235. TREATMENT - p. 2142 1236. MANAGEMENT OF PERSISTENT, RECURRENT OR METASTATIC DISEASE - p. 2143 1237. COMPLICATIONS OF PRIMARY NPC TREATMENT - p. 2149 1238. 136 Oral Cavity Cancer - p. 2155 1239. ANATOMY - p. 2155 1240. EPIDEMIOLOGY - p. 2159 1241. ETIOLOGY - p. 2159 1242. PRESENTATION - p. 2160 1243. DIAGNOSIS AND EVALUATION - p. 2161 1244. STAGING AND PROGNOSIS - p. 2165 1245. TREATMENT - p. 2166 1246. COMPLICATIONS - p. 2173 1247. FUTURE DIRECTIONS - p. 2174 1248. 137 Oropharyngeal Cancer - p. 2181 1249. INTRODUCTION - p. 2181 1250. ANATOMY - p. 2181 1251. PHYSIOLOGY - p. 2183 1252. ETIOLOGY - p. 2183 1253. HISTOPATHOLOGY - p. 2184 1254. NATURAL HISTORY - p. 2185 1255. DIAGNOSIS - p. 2187 1256. TREATMENT PLANNING - p. 2189 1257. RECONSTRUCTION - p. 2192 1258. EMERGENCIES - p. 2192 1259. FOLLOW-UP - p. 2192 1260. PROGNOSIS - p. 2192 1261. NEW AND DEVELOPING TREATMENTS - p. 2193 1262. 138 Unknown Primary Cancer of the Head and Neck - p. 2197 1263. INTRODUCTION - p. 2197 1264. EPIDEMIOLOGY - p. 2197 1265. HISTOPATHOLOGY - p. 2197 1266. PUTATIVE OCCULT PRIMARY SITES IN THE HEAD AND NECK - p. 2198 1267. STAGING - p. 2199 1268. WORKUP - p. 2199 1269. CONCLUSION - p. 2206 1270. 139 Robotics in Head and Neck Surgery - p. 2210 1271. INTRODUCTION - p. 2210 1272. CURRENT ROBOTIC SYSTEMS - p. 2210 1273. PATIENT SELECTION FOR TORS (Fig. 139.2) - p. 2211 1274. AIRWAY MANAGEMENT - p. 2213 1275. EXPOSURE - p. 2216 1276. OROPHARYNGEAL CANCER - p. 2216 1277. CANCER OF UNKNOWN PRIMARY - p. 2220 1278. LARYNGEAL CANCER - p. 2221 1279. NASOPHARYNX AND ANTERIOR CRANIAL BASE - p. 2221 1280. PARAPHARYNGEAL SPACE - p. 2222 1281. THYROID - p. 2222 1282. PARATHYROID - p. 2223 1283. CERVICAL LYMPH NODE DISSECTION - p. 2223 1284. RECONSTRUCTION - p. 2223 1285. CONTROVERSIES IN ROBOTIC SURGERY - p. 2223 1286. CONCLUSIONS - p. 2225 1287. 140 Hypopharyngeal and Cervical Esophageal Carcinoma - p. 2228 1288. INTRODUCTION - p. 2228 1289. ANATOMY - p. 2228 1290. EPIDEMIOLOGY - p. 2229 1291. ETIOLOGY - p. 2230 1292. DIAGNOSIS - p. 2230 1293. PATHOLOGY - p. 2233 1294. PROGNOSIS - p. 2234 1295. MANAGEMENT - p. 2235 1296. MANAGEMENT OF THE NECK - p. 2243 1297. RECONSTRUCTION - p. 2243 1298. NONSURGICAL THERAPIES FOR HYPOPHARYNGEAL AND CERVICAL ESOPHAGEAL CARCINOMA - p. 2244 1299. SALVAGE SURGERY - p. 2246 1300. FUNCTIONAL OUTCOMES - p. 2247 1301. COMPLICATIONS - p. 2247 1302. 141 Early Laryngeal Cancer - p. 2252 1303. EPIDEMIOLOGY - p. 2252 1304. RISK FACTORS - p. 2252 1305. TUMOR BIOLOGY - p. 2252 1306. ANATOMY OF THE LARYNX - p. 2253 1307. PREINVASIVE LESIONS - p. 2254 1308. EARLY SUPRAGLOTTIC CANCER - p. 2255 1309. SURGERY - p. 2257 1310. SURGICAL OUTCOMES - p. 2263 1311. RADIOTHERAPY - p. 2263 1312. EARLY GLOTTIC CANCER - p. 2264 1313. RADIOTHERAPY - p. 2273 1314. EARLY SUBGLOTTIC CANCER - p. 2275 1315. TREATMENT - p. 2275 1316. SUMMARY - p. 2276 1317. ACKNOWLEDGMENTS - p. 2276 1318. 142 Advanced Laryngeal Cancer - p. 2282 1319. INTRODUCTION - p. 2282 1320. EPIDEMIOLOGY - p. 2282 1321. ETIOLOGY - p. 2282 1322. PATHOLOGY - p. 2282 1323. ANATOMY - p. 2283 1324. PATTERNS OF SPREAD - p. 2283 1325. CLINICAL ASSESSMENT - p. 2284 1326. INVESTIGATION - p. 2284 1327. STAGING - p. 2286 1328. TREATMENT - p. 2287 1329. OUTCOMES - p. 2293 1330. 143 Tracheal Tumors - p. 2298 1331. INTRODUCTION - p. 2298 1332. CLINICAL PRESENTATION AND EVALUATION - p. 2298 1333. PATHOLOGY - p. 2300 1334. INITIAL AIRWAY MANAGEMENT - p. 2301 1335. DEFINITIVE SURGICAL MANAGEMENT - p. 2301 1336. ENDOSCOPIC AND NONOPERATIVE MANAGEMENT - p. 2306 1337. 144 Soft Tissue Tumors of the Head and Neck - p. 2310 1338. INTRODUCTION - p. 2310 1339. HEAD AND NECK PARAGANGLIOMAS - p. 2310 1340. SCHWANNOMAS OF THE HEAD AND NECK - p. 2316 1341. SOFT TISSUE SARCOMAS OF THE HEAD AND NECK - p. 2319 1342. 145 Lymphomas of the Head and Neck - p. 2327 1343. INTRODUCTION - p. 2327 1344. EPIDEMIOLOGY - p. 2327 1345. CLINICAL DIAGNOSIS AND IMAGING - p. 2328 1346. TISSUE DIAGNOSIS - p. 2330 1347. STAGING - p. 2330 1348. THERAPY - p. 2331 1349. LYMPHOMA SPECIFIC TO THE HEAD AND NECK - p. 2333 1350. CONCLUSION - p. 2337 1351. 146 Neoplasms of the Nose and Paranasal Sinuses - p. 2342 1352. BACKGROUND - p. 2342 1353. EVALUATION AND WORK-UP - p. 2342 1354. PATHOLOGY, TREATMENT, AND PROGNOSIS - p. 2344 1355. BENIGN TUMORS - p. 2344 1356. BENIGN PATHOLOGIES - p. 2345 1357. WHO CLASSIFICATION OF TUMORS - p. 2346 1358. CARCINOMAS - p. 2346 1359. SURGERY - p. 2352 1360. CONCLUSION - p. 2353 1361. 147 Orbital Tumors - p. 2357 1362. INTRODUCTION - p. 2357 1363. VASCULAR TUMORS - p. 2360 1364. HEMATOPOIETIC TUMORS - p. 2361 1365. NEURAL TUMORS - p. 2363 1366. INFLAMMATORY TUMORS - p. 2364 1367. CYSTS - p. 2365 1368. MESENCHYMAL TUMORS - p. 2366 1369. LACRIMAL TUMORS - p. 2368 1370. SECONDARY LESIONS - p. 2368 1371. METASTATIC TUMORS - p. 2369 1372. SURGICAL APPROACHES - p. 2369 1373. GENERAL OPERATIVE PRINCIPLES AND POSTOPERATIVE CARE - p. 2371 1374. INFERIOR APPROACH (INFERIOR FORNIX, TRANSCONJUNCTIVAL) - p. 2373 1375. LATERAL APPROACH (LATERAL RETROCANTHAL + OPTIONAL CANTHOTOMY–CANTHOLYSIS) - p. 2374 1376. CONCLUSION - p. 2374 1377. 148 Cranial Base Surgery - p. 2377 1378. INTRODUCTION - p. 2377 1379. HISTORY - p. 2377 1380. ANATOMY - p. 2378 1381. CLINICAL DIFFERENTIAL DIAGNOSIS - p. 2381 1382. IMAGING IN CRANIAL BASE SURGERY - p. 2382 1383. OPERATIVE MANAGEMENT - p. 2382 1384. COMPLICATIONS - p. 2390 1385. CONCLUSION - p. 2391 1386. 149 Odontogenic Cysts, Tumors, and Related Jaw Lesions - p. 2394 1387. INTRODUCTION - p. 2394 1388. ODONTOGENIC CYSTS - p. 2394 1389. INFLAMMATORY CYSTS - p. 2394 1390. DEVELOPMENTAL CYSTS - p. 2395 1391. NONODONTOGENIC CYSTS - p. 2398 1392. ODONTOGENIC TUMORS - p. 2398 1393. RELATED JAW LESIONS - p. 2405 1394. CONCLUSION - p. 2411 1395. 150 Thyroid Neoplasms - p. 2414 1396. INTRODUCTION - p. 2414 1397. HISTOLOGY OF THE NORMAL THYROID GLAND - p. 2414 1398. 151 Hyperparathyroidism: Evaluation and Surgical Management - p. 2423 1399. INTRODUCTION - p. 2423 1400. EMBRYOLOGY AND ANATOMICAL CONSIDERATIONS - p. 2423 1401. CALCIUM HOMEOSTASIS - p. 2423 1402. PARATHYROID GLAND HISTOLOGY - p. 2424 1403. HYPERPARATHYROIDISM - p. 2424 1404. CLINICAL MANIFESTATIONS - p. 2425 1405. EVALUATION - p. 2425 1406. INDICATIONS FOR SURGERY - p. 2428 1407. PARATHYROIDECTOMY - p. 2429 1408. MEDIASTINAL ADENOMA - p. 2434 1409. PARATHYROID CARCINOMA - p. 2435 1410. POSTOPERATIVE CARE - p. 2435 1411. 152 Surveillance and Survivorship in Head and Neck Cancer - p. 2440 1412. INTRODUCTION—WHY SURVIVORSHIP? - p. 2440 1413. CURRENT SURVIVORSHIP MODELS - p. 2440 1414. SURVEILLANCE - p. 2440 1415. PATIENT-REPORTED OUTCOME MEASURES - p. 2441 1416. CHOOSING A CLINICAL MODEL - p. 2442 1417. SPECIFIC LLE - p. 2444 1418. QOL IN HNC SURVIVORS - p. 2445 1419. FINANCIAL TOXICITY - p. 2446 1420. REHABILITATION - p. 2446 1421. NEXT STEPS - p. 2446 1422. CONCLUSION - p. 2447 1423. 153 Swallowing Therapy in Head and Neck Cancers and Late Effects of Therapy in Head and Neck Cancers - p. 2451 1424. INTRODUCTION - p. 2451 1425. DYSPHAGIA AFTER HEAD AND NECK SURGERY - p. 2452 1426. RADIATION THERAPY - p. 2454 1427. TREATMENT OF DYSPHAGIA IN HEAD AND NECK CANCERS - p. 2456 1428. MANAGEMENT OF END-STAGE DYSPHAGIA - p. 2460 1429. MULTIDISCIPLINARY TEAM - p. 2461 1430. CONCLUSION - p. 2461 1431. 154 Voice Restoration after Total Laryngectomy - p. 2464 1432. INTRODUCTION - p. 2464 1433. SHUNTS AND VALVES - p. 2465 1434. PRIMARY VERSUS SECONDARY TE PUNCTURE - p. 2466 1435. PATIENT SELECTION AND TIMING - p. 2466 1436. SURGICAL PROCEDURE—SECONDARY TE PUNCTURE - p. 2467 1437. SURGICAL PROCEDURE—PRIMARY TE PUNCTURE - p. 2468 1438. TREATMENT OF PHARYNGEAL CONSTRICTOR SPASM - p. 2469 1439. COMPLICATIONS - p. 2471 1440. POSTOPERATIVE REHABILITATION - p. 2471 1441. PREDICTORS OF SUCCESSFUL TRACHEOESOPHAGEAL SPEECH - p. 2472 1442. VOICE QUALITY - p. 2473 1443. EMERGENCIES - p. 2473 1444. SECTION VIII: SLEEP MEDICINE AND SURGERY - p. 2477 1445. 155 Sleep Medicine for the Otolaryngologist - p. 2479 1446. INTRODUCTION - p. 2479 1447. OVERVIEW OF NORMAL SLEEP - p. 2479 1448. OVERVIEW OF SLEEP DISORDERS—THE SLEEPY PATIENT - p. 2479 1449. EVALUATION OF THE PATIENT WITH A SLEEP DISORDER - p. 2484 1450. RADIOLOGIC EVALUATION OF THE AIRWAY IN SLEEP-DISORDERED BREATHING - p. 2497 1451. DIAGNOSIS OF SLEEP DISORDERS - p. 2498 1452. TREATMENT OF SLEEP DISORDERS - p. 2501 1453. 156 Medical Therapy for Obstructive Sleep Apnea - p. 2505 1454. INTRODUCTION - p. 2505 1455. POSITIVE AIRWAY PRESSURE - p. 2505 1456. ORAL APPLIANCE THERAPY FOR OSA - p. 2512 1457. RESULTS - p. 2515 1458. WEIGHT LOSS - p. 2516 1459. OTHER ADJUNCTIVE THERAPY - p. 2517 1460. TREATMENT OF ASSOCIATED CONDITIONS - p. 2520 1461. 157 Obstructive Sleep Apnea: Pathophysiology, Drug-Induced Sleep Endoscopy, and Endotyping - p. 2525 1462. INTRODUCTION - p. 2525 1463. ANATOMIC CONTRIBUTIONS TO OSA PATHOPHYSIOLOGY - p. 2525 1464. NONANATOMIC CONTRIBUTIONS TO OSA PATHOPHYSIOLOGY - p. 2530 1465. CONCLUSION - p. 2532 1466. 158 Nonapneic Snoring and Upper Airway Resistance Syndrome - p. 2536 1467. INTRODUCTION - p. 2536 1468. BACKGROUND INFORMATION - p. 2536 1469. SNORING TREATMENT - p. 2537 1470. 159 Nasal Surgery for Sleep-disordered Breathing - p. 2542 1471. NASAL AIRWAY ANATOMY - p. 2542 1472. NASAL OBSTRUCTION - p. 2542 1473. CONCLUSION - p. 2549 1474. 160 Pharyngeal Surgery - p. 2551 1475. INTRODUCTION - p. 2551 1476. DIAGNOSIS AND EVALUATION - p. 2552 1477. ROLE OF DISE IN SURGICAL PLANNING - p. 2554 1478. PALATE SURGERY - p. 2554 1479. LOWER PHARYNGEAL SURGERY - p. 2560 1480. FUTURE DIRECTIONS - p. 2564 1481. 161 Neurostimulation - p. 2568 1482. INTRODUCTION - p. 2568 1483. SELECTION CRITERIA - p. 2568 1484. SURGICAL TECHNIQUE - p. 2570 1485. IMMEDIATE FOLLOW-UP AND PROGRAMMING - p. 2573 1486. ADVERSE EVENTS AND MANAGEMENT - p. 2575 1487. SPECIAL SURGICAL CIRCUMSTANCES - p. 2578 1488. DEVELOPMENT AND EFFICACY - p. 2580 1489. MULTIDISCIPLINARY APPROACH - p. 2581 1490. OTHER NEUROSTIMULATION DEVICES FOR TREATMENT OF SLEEP APNEA - p. 2581 1491. FUTURE DIRECTIONS - p. 2582 1492. 162 Skeletal Surgery - p. 2584 1493. INTRODUCTION - p. 2584 1494. MAXILLOMANDIBULAR ADVANCEMENT - p. 2584 1495. GENIOGLOSSUS ADVANCEMENT - p. 2588 1496. RAPID MAXILLARY EXPANSION - p. 2591 1497. CONCLUSION - p. 2595 1498. SECTION IX: OTOLOGY AND NEUROTOLOGY - p. 2599 1499. 163 Development of the Ear - p. 2601 1500. AURICULAR DEVELOPMENT - p. 2601 1501. DEVELOPMENTAL ANOMALIES - p. 2602 1502. DEVELOPMENT OF THE EXTERNAL AND MIDDLE EAR - p. 2603 1503. DEVELOPMENT OF THE FACIAL NERVE - p. 2606 1504. DEVELOPMENT OF THE INNER EAR - p. 2606 1505. DEVELOPMENT OF INNERVATION OF THE MEMBRANOUS LABYRINTH - p. 2609 1506. DEVELOPMENT OF THE OSSEOUS LABYRINTH - p. 2609 1507. DEVELOPMENT OF THE OTIC CAPSULE - p. 2609 1508. CONTROL OF EAR DEVELOPMENT - p. 2612 1509. 164 Anatomy and Physiology of Hearing - p. 2616 1510. INTRODUCTION - p. 2616 1511. EXTERNAL EAR - p. 2616 1512. TYMPANIC MEMBRANE - p. 2619 1513. MIDDLE EAR - p. 2620 1514. COCHLEA - p. 2624 1515. ORGAN OF CORTI - p. 2627 1516. SUMMARY OF TRANSDUCTION - p. 2631 1517. COCHLEAR NUCLEUS - p. 2632 1518. SUPERIOR OLIVARY COMPLEX - p. 2633 1519. LATERAL LEMNISCUS - p. 2633 1520. INFERIOR COLLICULUS - p. 2633 1521. MEDIAL GENICULATE BODY OF THE THALAMUS - p. 2633 1522. AUDITORY CORTEX - p. 2634 1523. THE EFFERENT AUDITORY PATHWAY - p. 2634 1524. BRAINSTEM AUDITORY EVOKED POTENTIALS - p. 2635 1525. IN SUMMARY - p. 2636 1526. ACKNOWLEDGMENTS - p. 2636 1527. 165 Assessment of Peripheral and Central Auditory Function - p. 2639 1528. INTRODUCTION - p. 2639 1529. BASIC AUDIOLOGIC TEST BATTERY - p. 2639 1530. OTOACOUSTIC EMISSIONS - p. 2644 1531. GUIDELINES FOR EVALUATION OF HEARING HANDICAP - p. 2657 1532. AUDITORY EVOKED RESPONSES - p. 2658 1533. ASSESSMENT OF AUDITORY PROCESSING DISORDERS - p. 2663 1534. STAFF TRAINING AND AUTOMATED TESTING - p. 2664 1535. GLOSSARY - p. 2665 1536. 166 Vestibular Function and Anatomy - p. 2669 1537. GROSS ANATOMY OF THE VESTIBULAR SYSTEM - p. 2669 1538. CELLULAR ANATOMY OF THE VESTIBULAR END ORGANS - p. 2674 1539. PHYSICS OF MECHANOTRANSDUCTION - p. 2676 1540. VESTIBULAR BRAINSTEM - p. 2678 1541. VESTIBULAR TESTING - p. 2679 1542. CURRENT AREAS OF RESEARCH - p. 2679 1543. 167 Assessment of Vestibular and Balance Function Using Laboratory Testing - p. 2681 1544. INTRODUCTION - p. 2681 1545. LABORATORY ASSESSMENT OF THE OCULAR MOTOR SYSTEM - p. 2682 1546. LABORATORY ASSESSMENT OF THE SEMICIRCULAR CANALS - p. 2685 1547. LABORATORY ASSESSMENT OF THE OTOLITH ORGANS - p. 2691 1548. THE USE OF VESTIBULAR STUDIES FOR LOCALIZATION OF IMPAIRMENT IN COMMON OTOLOGIC DISORDERS - p. 2697 1549. 168 Neurophysiologic Intraoperative Monitoring - p. 2704 1550. INTRODUCTION - p. 2704 1551. AUDITORY SYSTEM MONITORING - p. 2704 1552. INTRAOPERATIVE FACIAL NERVE MONITORING - p. 2713 1553. MONITORING OTHER CRANIAL NERVES - p. 2719 1554. CONCLUSION - p. 2719 1555. 169 Diseases of the External Ear - p. 2724 1556. EMBRYOLOGY - p. 2724 1557. ANATOMY AND PHYSIOLOGY - p. 2724 1558. INFECTIONS OF THE EXTERNAL EAR - p. 2726 1559. NONINFECTIOUS DISORDERS OF THE EXTERNAL EAR - p. 2738 1560. 170 Eustachian Tube Dysfunction - p. 2751 1561. INTRODUCTION - p. 2751 1562. ANATOMY AND PHYSIOLOGY OF THE EUSTACHIAN TUBE - p. 2751 1563. DIAGNOSIS AND EVALUATION OF EUSTACHIAN TUBE DYSFUNCTION - p. 2752 1564. DIFFERENTIAL DIAGNOSIS FOR AURAL FULLNESS - p. 2755 1565. OBSTRUCTIVE EUSTACHIAN TUBE DYSFUNCTION - p. 2757 1566. PATULOUS EUSTACHIAN TUBE DYSFUNCTION - p. 2762 1567. CONCLUSION - p. 2765 1568. 171 Intratemporal and Intracranial Complications of Otitis Media - p. 2770 1569. INTRODUCTION - p. 2770 1570. PATHOPHYSIOLOGY - p. 2770 1571. GENERAL PATTERNS OF PRESENTATION - p. 2772 1572. INTRATEMPORAL (EXTRACRANIAL) COMPLICATIONS - p. 2773 1573. INTRACRANIAL COMPLICATIONS - p. 2777 1574. 172 Middle Ear and Temporal Bone Trauma - p. 2783 1575. INTRODUCTION - p. 2783 1576. EPIDEMIOLOGY - p. 2783 1577. PATHOPHYSIOLOGY - p. 2783 1578. CLASSIFICATION - p. 2783 1579. MANAGEMENT - p. 2787 1580. 173 Cholesteatoma—Pathogenesis and Treatment - p. 2801 1581. INTRODUCTION - p. 2801 1582. CONGENITAL CHOLESTEATOMA - p. 2801 1583. ACQUIRED CHOLESTEATOMA - p. 2802 1584. SURGICAL ANATOMY - p. 2804 1585. PREVENTION - p. 2806 1586. PREOPERATIVE EVALUATION - p. 2808 1587. SURGICAL MANAGEMENT - p. 2809 1588. COMPLICATIONS AND EMERGENCIES - p. 2811 1589. 174 Surgery of the Mastoid and Petrosa - p. 2819 1590. HISTORY - p. 2819 1591. INDICATIONS FOR MASTOIDECTOMY - p. 2819 1592. SURGICAL TECHNIQUE: MASTOIDECTOMY - p. 2819 1593. MANAGING THE CANAL-WALL-DOWN CAVITY - p. 2828 1594. MASTOIDECTOMY FOR ENDOLYMPHATIC HYDROPS - p. 2829 1595. MASTOIDECTOMY FOR SEMICIRCULAR CANAL OCCLUSION - p. 2830 1596. MASTOIDECTOMY FOR CEREBROSPINAL FLUID LEAK - p. 2830 1597. PETROUS APICECTOMY - p. 2831 1598. COMPLICATIONS AND EMERGENCIES (TABLE 174.3) - p. 2832 1599. 175 Reconstruction of the Tympanic Membrane and Ossicular Chain - p. 2837 1600. INTRODUCTION - p. 2837 1601. DEFINITION OF TERMS - p. 2837 1602. TYPES OF TYMPANOPLASTY AND OSSICULAR RECONSTRUCTION - p. 2837 1603. PHYSIOLOGY: MECHANISMS OF GAIN - p. 2838 1604. PREOPERATIVE EVALUATION - p. 2839 1605. TYMPANOPLASTY - p. 2841 1606. OSSICULOPLASTY - p. 2849 1607. RESULTS - p. 2856 1608. 176 Otosclerosis - p. 2859 1609. EMBRYOLOGY - p. 2859 1610. HISTOLOGY - p. 2859 1611. BASIC SCIENCE - p. 2860 1612. PATHOPHYSIOLOGY - p. 2860 1613. EPIDEMIOLOGY - p. 2861 1614. HISTORY AND PHYSICAL EXAMINATION - p. 2862 1615. AUDIOLOGIC TESTING - p. 2862 1616. DIFFERENTIAL DIAGNOSIS - p. 2862 1617. MANAGEMENT - p. 2864 1618. AMPLIFICATION - p. 2864 1619. MEDICAL MANAGEMENT - p. 2865 1620. SURGICAL MANAGEMENT - p. 2865 1621. PATIENT SELECTION AND CONTRAINDICATIONS - p. 2866 1622. ENDOSCOPIC STAPES SURGERY - p. 2867 1623. PATIENT COUNSELING - p. 2867 1624. SURGICAL TECHNIQUE - p. 2867 1625. COMPLICATIONS/PITFALLS - p. 2873 1626. 177 Acute Paralysis of the Facial Nerve - p. 2877 1627. INTRODUCTION - p. 2877 1628. ANATOMY AND PHYSIOLOGY OF THE FACIAL NERVE - p. 2877 1629. SURGICAL ANATOMY - p. 2878 1630. EVALUATION - p. 2879 1631. PATHOPHYSIOLOGY OF NERVE INJURY - p. 2882 1632. BELL PALSY - p. 2884 1633. HERPES ZOSTER OTICUS - p. 2886 1634. OTITIS MEDIA AND FACIAL PALSY - p. 2887 1635. TRAUMA - p. 2887 1636. TUMORS OF THE SKULL BASE AND FACIAL NERVE - p. 2890 1637. FACIAL PALSY IN THE NEWBORN - p. 2891 1638. EYE CARE - p. 2892 1639. 178 Otologic Manifestations of Systemic Disease - p. 2895 1640. INTRODUCTION - p. 2895 1641. INFECTIOUS DISEASE - p. 2895 1642. GRANULOMATOUS DISEASE - p. 2898 1643. AUTOIMMUNE DISEASE - p. 2899 1644. INFLAMMATORY DISEASE - p. 2903 1645. DISEASES OF BONE - p. 2903 1646. METABOLIC DISORDERS - p. 2905 1647. PARANEOPLASTIC SYNDROMES AND MALIGNANCY - p. 2905 1648. 179 Noise-Induced Hearing Loss - p. 2909 1649. INTRODUCTION - p. 2909 1650. PATHOGENESIS - p. 2909 1651. EVALUATION AND DIAGNOSIS - p. 2919 1652. MANAGEMENT - p. 2924 1653. NONAUDITORY EFFECTS - p. 2926 1654. THE IMPORTANCE OF PREVENTION - p. 2926 1655. ACKNOWLEDGMENTS - p. 2927 1656. 180 Ototoxicity - p. 2936 1657. INTRODUCTION - p. 2936 1658. SYSTEMIC OTOTOXICITY - p. 2936 1659. TOPICAL OTOTOXICITY - p. 2938 1660. GENETICS OF OTOTOXICITY - p. 2939 1661. OTOPROTECTIVE STRATEGIES - p. 2940 1662. CLINICAL MONITORING OF OTOTOXICITY - p. 2941 1663. 181 Cerebrospinal Fluid Otorrhea - p. 2950 1664. INTRODUCTION - p. 2950 1665. PATHOPHYSIOLOGY - p. 2950 1666. DIAGNOSIS AND WORKUP - p. 2950 1667. TREATMENT - p. 2953 1668. CONCLUSION - p. 2957 1669. 182 Cerebellopontine Angle Tumors - p. 2959 1670. INTRODUCTION - p. 2959 1671. EXTRA-AXIAL LESIONS - p. 2961 1672. INTRA-AXIAL LESIONS - p. 2980 1673. SKULL BASE LESIONS - p. 2980 1674. CONCLUSION - p. 2984 1675. 183 Other Neoplasms of the Ear and Lateral Skull Base - p. 2991 1676. INTRODUCTION - p. 2991 1677. NEOPLASMS OF THE EXTERNAL EAR AND EXTERNAL AUDITORY CANAL - p. 2991 1678. NEOPLASMS OF THE MIDDLE EAR, MASTOID, AND TEMPORAL BONE - p. 3004 1679. NEOPLASMS OF THE INTERNAL AUDITORY CANAL AND CEREBELLOPONTINE ANGLE - p. 3012 1680. NEOPLASMS OF CELL-SPECIFIC ORIGIN - p. 3017 1681. METASTATIC DISEASE OF THE TEMPORAL BONE AND LATERAL SKULL BASE - p. 3026 1682. SURGICAL APPROACHES - p. 3027 1683. SUMMARY - p. 3028 1684. QUALITY OF LIFE AND REHABILITATION OF CRANIAL NERVE DEFICITS - p. 3029 1685. 184 Stereotactic Radiosurgery - p. 3035 1686. PRINCIPALS OF RADIATION THERAPY - p. 3035 1687. GAMMA KNIFE RADIOSURGERY - p. 3036 1688. PATIENT SELECTION - p. 3036 1689. ALTERNATIVE STEREOTACTIC RADIOSURGERY TECHNOLOGIES - p. 3053 1690. ALTERNATIVE APPLICATIONS - p. 3056 1691. SUMMARY - p. 3058 1692. 185 Sudden Sensorineural Hearing Loss - p. 3060 1693. INTRODUCTION - p. 3060 1694. BACKGROUND - p. 3060 1695. DIFFERENTIAL DIAGNOSIS - p. 3060 1696. EVALUATION - p. 3062 1697. TREATMENT - p. 3063 1698. RESULTS - p. 3065 1699. OUTCOMES ASSESSMENT AND PROGNOSIS - p. 3067 1700. COUNSELING AND REHABILITATION - p. 3067 1701. CONCLUSION - p. 3067 1702. 186 Tinnitus and Hyperacusis - p. 3071 1703. INTRODUCTION - p. 3071 1704. HISTORY AND PHYSICAL EXAMINATION - p. 3071 1705. SUBJECTIVE NONPULSATILE TINNITUS - p. 3073 1706. PULSATILE TINNITUS - p. 3080 1707. DIAGNOSTIC EVALUATION - p. 3080 1708. 187 Aging and the Auditory and Vestibular System - p. 3090 1709. INTRODUCTION - p. 3090 1710. AGING AND THE AUDITORY SYSTEM - p. 3090 1711. AGING AND THE VESTIBULAR SYSTEM - p. 3096 1712. CONCLUSION - p. 3100 1713. 188 Cochlear Implants and Other Implantable Auditory Prostheses - p. 3105 1714. INTRODUCTION - p. 3105 1715. COCHLEAR IMPLANTS - p. 3105 1716. BONE CONDUCTION IMPLANTS - p. 3121 1717. ACTIVE MIDDLE EAR IMPLANTS - p. 3129 1718. AUDITORY CNS IMPLANTS - p. 3134 1719. ACKNOWLEDGMENTS - p. 3136 1720. 189 “Heads Up” Ear Surgery: Endoscopes for Otology and Neurotology - p. 3141 1721. INTRODUCTION - p. 3141 1722. JUSTIFICATION FOR ENDOSCOPIC EAR SURGERY - p. 3141 1723. TERMINOLOGY AND CLASSIFICATION SYSTEMS - p. 3143 1724. APPLICATIONS OF ENDOSCOPIC EAR SURGERY IN OTOLOGY AND NEUROTOLOGY - p. 3143 1725. SURGICAL ERGONOMICS FOR ENDOSCOPIC EAR SURGERY - p. 3149 1726. INCORPORATING ENDOSCOPIC EAR SURGERY INTO CLINICAL PRACTICE - p. 3150 1727. CONCLUSION - p. 3152 1728. 190 Hearing Aids and Assistive Listening Devices - p. 3157 1729. POPULATION - p. 3157 1730. GOAL OF AMPLIFICATION - p. 3158 1731. BASICS OF THE AMPLIFICATION SYSTEM - p. 3158 1732. HEARING AID FITTING PROTOCOLS - p. 3158 1733. HEARING LOSS AND CANDIDACY - p. 3158 1734. EVALUATION - p. 3159 1735. PRESELECTION DECISIONS - p. 3160 1736. HEARING AID FITTING - p. 3168 1737. PRESETTING AND VERIFICATION - p. 3172 1738. ORIENTATION - p. 3174 1739. OUTCOME ASSESSMENT - p. 3174 1740. ASSISTIVE TECHNOLOGY BEYOND THE HEARING AID - p. 3175 1741. PROBLEMS FREQUENTLY ENCOUNTERED BY HEARING AID USERS IN HEALTH CARE SETTINGS - p. 3176 1742. CONCLUSION - p. 3176 1743. ACKNOWLEDGMENTS - p. 3176 1744. 191 Clinical Evaluation of the Patient with Vertigo - p. 3182 1745. INTRODUCTION - p. 3182 1746. HISTORY TAKING - p. 3184 1747. OFFICE NEUROTOLOGIC EXAMINATION - p. 3191 1748. EMERGENCY ROOM NEUROTOLOGIC EXAMINATION OF PATIENTS WITH ACUTE VESTIBULAR SYNDROME - p. 3207 1749. CONCLUSION - p. 3208 1750. 192 Peripheral Vestibular Disorders - p. 3212 1751. GENERAL PRINCIPLES - p. 3212 1752. BRIEF EPISODIC EXCITATION OF UNILATERAL VESTIBULAR FUNCTION - p. 3213 1753. EPISODIC DISRUPTION OF UNILATERAL VESTIBULAR FUNCTION - p. 3218 1754. CHRONICALLY INADEQUATE VESTIBULAR FUNCTION - p. 3224 1755. 193 Central Vestibular Disorders - p. 3231 1756. INTRODUCTION - p. 3231 1757. CANVAS - p. 3248 1758. 194 Vestibular Rehabilitation - p. 3259 1759. INTRODUCTION AND BACKGROUND - p. 3259 1760. AUDIOLOGIST’S ROLE IN VESTIBULAR REHABILITATION - p. 3260 1761. PHYSICAL THERAPIST’S ROLE IN VR - p. 3261 1762. CONCLUSION - p. 3262 1763. VIDEO SUPPLEMENT TO TEXT - p. 3263 1764. 195 Regenerative Strategies for Overcoming Deafness - p. 3265 1765. INTRODUCTION - p. 3265 1766. HAIR CELL REGENERATION, NONMAMMALIAN VERTEBRATES VERSUS MAMMALS - p. 3265 1767. NOTCH AND WNT PATHWAYS - p. 3266 1768. Atoh1 Gene Therapy - p. 3267 1769. CELL CYCLE INHIBITION - p. 3267 1770. SOMATIC STEM CELLS - p. 3268 1771. EMBRYONIC STEM CELLS AND INDUCED PLURIPOTENT STEM CELLS - p. 3268 1772. ORGANOIDS AS A MODEL TO STUDY HAIR CELL REGENERATION - p. 3269 1773. SUMMARY - p. 3270 1774. ACKNOWLEDGMENTS - p. 3270 1775. SECTION X: FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY - p. 3273 1776. 196 Preoperative Evaluation and Facial Analysis in Facial Plastic Surgery - p. 3275 1777. CONCEPT OF BEAUTY AND DEFORMITY - p. 3275 1778. INITIAL CONSULTATION - p. 3275 1779. PSYCHOPATHOLOGY IN THE AESTHETIC PATIENT - p. 3276 1780. FACIAL ANALYSIS - p. 3277 1781. METHODS OF FACIAL ANALYSIS - p. 3287 1782. CONCLUSION - p. 3288 1783. 197 Fundamentals of Photography for the Otolaryngologist - p. 3291 1784. INTRODUCTION - p. 3291 1785. INFORMED CONSENT - p. 3291 1786. CAMERA AND EQUIPMENT - p. 3291 1787. LIGHTING, BACKGROUND, AND PATIENT POSITIONING - p. 3296 1788. COMPUTER IMAGING SIMULATION - p. 3297 1789. INTRAOPERATIVE PHOTOGRAPHS - p. 3299 1790. DIGITAL IMAGE STORAGE, POSTPROCESSING, AND MANAGEMENT - p. 3300 1791. CONCLUSION - p. 3300 1792. 198 Local Cutaneous Flaps and Grafts - p. 3302 1793. INTRODUCTION - p. 3302 1794. SKIN ANATOMY - p. 3302 1795. SKIN BIOMECHANICAL PROPERTIES - p. 3303 1796. SKIN PHYSIOLOGY - p. 3304 1797. DEFECT ANALYSIS AND PREPARATION - p. 3305 1798. PATIENT PREPARATION—MEDICAL COMORBIDITIES - p. 3306 1799. HEALING BY SECONDARY INTENTION - p. 3307 1800. PRIMARY CLOSURE - p. 3307 1801. FACIAL CUTANEOUS FLAPS - p. 3307 1802. FACIAL CUTANEOUS GRAFTS - p. 3318 1803. COMPLICATIONS - p. 3323 1804. 199 Tissue Expanders - p. 3329 1805. INTRODUCTION - p. 3329 1806. SKIN BIOMECHANICS AND TYPES OF EXPANSION - p. 3329 1807. PHYSIOLOGY OF TISSUE EXPANSION - p. 3331 1808. APPLICATIONS - p. 3331 1809. EXPANDER DEVICES - p. 3332 1810. SURGICAL TECHNIQUES: CONVENTIONAL LONG-TERM TISSUE EXPANSION - p. 3333 1811. SURGICAL TECHNIQUES: RAPID INTRAOPERATIVE TISSUE EXPANSION - p. 3334 1812. COMPLICATIONS - p. 3337 1813. CONCLUSION - p. 3337 1814. 200 Scar Camouflage - p. 3339 1815. INTRODUCTION - p. 3339 1816. BASIC SCIENCE - p. 3339 1817. SURGICAL TECHNIQUES - p. 3340 1818. NONSURGICAL AND ADJUNCTIVE TECHNIQUES - p. 3346 1819. 201 Nasal Reconstruction - p. 3351 1820. INTRODUCTION - p. 3351 1821. HISTORY OF NASAL RECONSTRUCTION - p. 3351 1822. ETIOLOGY OF NASAL DEFECTS - p. 3352 1823. NASAL ANATOMY - p. 3352 1824. DEFECT ANALYSIS - p. 3356 1825. SMALL CUTANEOUS DEFECTS - p. 3357 1826. SELECTION OF GRAFTS AND FLAPS - p. 3358 1827. TECHNIQUES FOR GRAFTS AND FLAPS - p. 3359 1828. LARGE CUTANEOUS DEFECTS - p. 3368 1829. STRUCTURAL SUPPORT AND GRAFTING IN NASAL RECONSTRUCTION - p. 3378 1830. INTERNAL LINING DEFICITS - p. 3383 1831. COMPLICATIONS AND MANAGEMENT - p. 3393 1832. CONCLUSION - p. 3396 1833. 202 Lip Reconstruction - p. 3400 1834. INTRODUCTION - p. 3400 1835. ANATOMY - p. 3400 1836. MANAGEMENT OF LIP DEFECTS - p. 3402 1837. RECONSTRUCTIVE TECHNIQUES - p. 3403 1838. ACKNOWLEDGMENT - p. 3414 1839. 203 Auricular Reconstruction - p. 3415 1840. AURICULAR RECONSTRUCTION - p. 3415 1841. PREOPERATIVE CONSIDERATIONS - p. 3415 1842. ETIOLOGY - p. 3416 1843. ONCOLOGIC CONSIDERATIONS - p. 3416 1844. TRAUMATIC CONSIDERATIONS - p. 3417 1845. ANATOMY - p. 3417 1846. GENERAL PRINCIPLES OF RECONSTRUCTION - p. 3418 1847. LACERATIONS - p. 3420 1848. SUPERFICIAL DEFECTS - p. 3420 1849. SMALLER COMPOSITE DEFECTS - p. 3421 1850. CONCLUSION - p. 3444 1851. 204 Periorbital Reconstruction - p. 3446 1852. INTRODUCTION - p. 3446 1853. ANATOMY - p. 3446 1854. EVALUATION - p. 3451 1855. PRINCIPLES OF RECONSTRUCTION - p. 3452 1856. RECONSTRUCTIVE TECHNIQUES - p. 3453 1857. COMPLICATIONS - p. 3460 1858. BLEPHAROPTOSIS - p. 3462 1859. RECONSTRUCTION OF THE PARALYTIC EYELID - p. 3463 1860. CICATRICIAL ECTROPION - p. 3463 1861. MANAGEMENT OF THE EYELIDS IN POSTMAXILLECTOMY DEFECTS - p. 3465 1862. CONCLUSION - p. 3466 1863. 205 Facial Reanimation - p. 3468 1864. INTRODUCTION - p. 3468 1865. CLASSIFICATION OF FACIAL PALSY AND NERVE INJURY - p. 3468 1866. GLOBAL MANAGEMENT OF FACIAL PALSY - p. 3469 1867. FACIAL MANAGEMENT BY ZONE - p. 3472 1868. CONCLUSION - p. 3481 1869. 206 Surgical Anatomy of the Nose: A Foundation for Rhinoplasty - p. 3483 1870. GENERAL PRINCIPLES - p. 3483 1871. SURFACE ANATOMY - p. 3483 1872. SKIN–SOFT TISSUE ENVELOPE - p. 3488 1873. SKELETAL FRAMEWORK - p. 3490 1874. NASAL BASE - p. 3496 1875. MECHANICS AND STABILITY - p. 3497 1876. FUNCTIONAL VALVULAR ANATOMY - p. 3501 1877. ETHNIC VARIATIONS - p. 3502 1878. CONCLUSION - p. 3502 1879. 207 Rhinoplasty: Incisions, Approaches, and Analysis - p. 3505 1880. INTRODUCTION - p. 3505 1881. ANATOMIC LANDMARKS - p. 3505 1882. NASAL AND FACIAL ANGLES - p. 3506 1883. SURGICAL INCISIONS AND APPROACHES - p. 3507 1884. NASAL ANALYSIS - p. 3510 1885. CONCLUSION - p. 3514 1886. 208 The Nasal Dorsum: Management of the Upper Two-Thirds of the Nose - p. 3516 1887. INTRODUCTION - p. 3516 1888. ANATOMY - p. 3516 1889. NASAL ANALYSIS - p. 3518 1890. DEFECTS OF THE NASAL VAULTS - p. 3520 1891. MANAGEMENT OF THE CARTILAGINOUS VAULT - p. 3521 1892. MANAGEMENT OF THE BONY VAULT - p. 3522 1893. CONCLUSION - p. 3530 1894. 209 Management of Nasal Tip and Alar Base - p. 3532 1895. INTRODUCTION - p. 3532 1896. ANALYSIS AND DIAGNOSIS - p. 3532 1897. PREOPERATIVE PLANNING - p. 3538 1898. SURGICAL TECHNIQUES - p. 3538 1899. 210 Management of the Crooked Nose - p. 3550 1900. INTRODUCTION - p. 3550 1901. ANALYSIS - p. 3550 1902. ETIOLOGY - p. 3552 1903. ANATOMY - p. 3552 1904. MANAGEMENT - p. 3554 1905. COMPLICATIONS - p. 3562 1906. CONCLUSION - p. 3563 1907. 211 Functional Septorhinoplasty - p. 3564 1908. INTRODUCTION - p. 3564 1909. CAUSES OF NASAL OBSTRUCTION - p. 3564 1910. EVALUATION OF THE PATIENT PRESENTING WITH NASAL OBSTRUCTION - p. 3569 1911. TREATMENT OF NASAL VALVE COMPROMISE - p. 3570 1912. 212 Revision Rhinoplasty - p. 3579 1913. INTRODUCTION - p. 3579 1914. ASSESSING NASAL DEFORMITY AND SURGICAL INTOLERANCE - p. 3579 1915. PATIENT EVALUATION AND TREATMENT PLANNING - p. 3581 1916. SURGICAL RECONSTRUCTION OF THE PREVIOUSLY OPERATED NOSE - p. 3586 1917. AUGMENTATION GRAFTING OF THE OVERRESECTED NOSE - p. 3589 1918. OPTIONS FOR SKELETAL TISSUE REPLACEMENT - p. 3590 1919. EXTERNAL RHINOPLASTY APPROACH - p. 3596 1920. SOFT TISSUE SURGICAL TECHNIQUE - p. 3596 1921. SURGICAL DECONSTRUCTION OF THE PREVIOUSLY OPERATED NOSE - p. 3597 1922. RECONSTRUCTION OF THE SURGICALLY DEVASTATED NASAL TIP - p. 3599 1923. REVISION OF THE SURGICALLY DEVASTATED NASAL DORSUM - p. 3607 1924. AFTERCARE - p. 3613 1925. CONCLUSION - p. 3635 1926. 213 Cleft Septorhinoplasty - p. 3638 1927. INTRODUCTION - p. 3638 1928. RELEVANT EMBRYOLOGY - p. 3638 1929. RELEVANT CLINICAL ANATOMY - p. 3638 1930. UNILATERAL CLEFT LIP - p. 3639 1931. BILATERAL CLEFT LIP - p. 3640 1932. PRESURGICAL MANAGEMENT PRIOR TO THE PRIMARY CLEFT LIP REPAIR - p. 3641 1933. STAGES OF CLEFT SEPTORHINOPLASTY - p. 3643 1934. PRIMARY CLEFT RHINOPLASTY - p. 3643 1935. INTERMEDIATE CLEFT RHINOPLASTY - p. 3645 1936. DEFINITIVE CLEFT RHINOPLASTY - p. 3645 1937. AVOIDING COMPLICATIONS - p. 3648 1938. CONCLUSION - p. 3649 1939. 214 The Aging Forehead - p. 3651 1940. HISTORY - p. 3651 1941. FOREHEAD ANATOMY - p. 3651 1942. PHYSIOLOGY OF AGING - p. 3653 1943. BROW AESTHETICS - p. 3654 1944. ASSESSMENT - p. 3654 1945. PREOPERATIVE COUNSELING - p. 3655 1946. MANAGEMENT - p. 3656 1947. SURGICAL PROCEDURE AND TECHNIQUE - p. 3656 1948. COMPLICATIONS - p. 3670 1949. EMERGENCIES - p. 3672 1950. CONCLUSION - p. 3672 1951. 215 Upper Eyelid Blepharoplasty - p. 3675 1952. INTRODUCTION - p. 3675 1953. SURGICAL ANATOMY - p. 3675 1954. EVALUATION - p. 3678 1955. PHOTOGRAPHY - p. 3682 1956. GOALS OF SURGERY - p. 3682 1957. COMPLICATIONS - p. 3684 1958. CONCLUSION - p. 3685 1959. 216 Lower Eyelid Blepharoplasty - p. 3686 1960. LOWER EYELID ANATOMY - p. 3686 1961. IMPORTANT TERMINOLOGY - p. 3686 1962. PATIENT SELECTION AND EXAMINATION - p. 3687 1963. PHOTOGRAPHY AND CONSENTS - p. 3690 1964. SURGICAL PROCEDURE - p. 3690 1965. ADJUNCTIVE PROCEDURES - p. 3695 1966. COMPLICATIONS - p. 3700 1967. CONCLUSION - p. 3702 1968. ACKNOWLEDGMENT - p. 3702 1969. 217 Rhytidectomy and Platysmaplasty (Face-Lift and Neck Lift) - p. 3704 1970. INTRODUCTION - p. 3704 1971. GENERAL CONSIDERATIONS AND ADJUNCTIVE PROCEDURES - p. 3704 1972. PHYSIOLOGY OF THE AGING FACE - p. 3705 1973. SURGICAL ANATOMY - p. 3706 1974. SURGICAL EVOLUTION: A HISTORICAL PERSPECTIVE - p. 3708 1975. ASSESSING CANDIDACY - p. 3711 1976. PREOPERATIVE EVALUATION AND PLANNING - p. 3712 1977. PREOPERATIVE PREPARATION - p. 3714 1978. SURGICAL PLANNING - p. 3714 1979. OPERATIVE STAGE - p. 3717 1980. DEEP PLANE LIFT - p. 3722 1981. SPECIAL CONSIDERATIONS - p. 3727 1982. POSTOPERATIVE CARE - p. 3730 1983. COMPLICATIONS - p. 3731 1984. 218 Otoplasty: Anatomy, Embryology, and Otoplasty Technique - p. 3738 1985. INTRODUCTION - p. 3738 1986. ANATOMY AND EMBRYOLOGY - p. 3738 1987. AURICULAR ANOMALIES - p. 3740 1988. PATIENT SELECTION - p. 3743 1989. SURGICAL TECHNIQUES - p. 3744 1990. LONG-TERM RESULTS - p. 3754 1991. CONCLUSION - p. 3754 1992. 219 Congenital Auricular Malformation - p. 3757 1993. MICROTIA - p. 3757 1994. ANATOMY AND EMBRYOLOGY - p. 3757 1995. CLASSIFICATION - p. 3759 1996. HISTORY - p. 3759 1997. EVALUATION - p. 3761 1998. MATERIALS FOR RECONSTRUCTION - p. 3761 1999. SURGICAL PLANNING - p. 3764 2000. TECHNIQUES - p. 3765 2001. COMPLICATIONS - p. 3769 2002. EAR MOLDING - p. 3771 2003. AURICULAR PROSTHETICS - p. 3772 2004. CONCLUSION - p. 3772 2005. ACKNOWLEDGEMENT - p. 3772 2006. 220 Chin Augmentation - p. 3774 2007. INTRODUCTION - p. 3774 2008. PATIENT EVALUATION - p. 3774 2009. CLASSIFICATION OF CHIN DEFORMITIES - p. 3778 2010. SELECTION OF PROCEDURE - p. 3780 2011. PROCEDURAL DETAILS - p. 3780 2012. COMPLICATIONS - p. 3785 2013. CONCLUSION - p. 3786 2014. 221 Facial Resurfacing - p. 3788 2015. INTRODUCTION - p. 3788 2016. ANATOMY OF THE SKIN - p. 3788 2017. CONTRAINDICATIONS TO RESURFACING PROCEDURES - p. 3789 2018. ABLATIVE VERSUS NONABLATIVE RESURFACING - p. 3789 2019. PREPROCEDURE SKIN PREPARATION - p. 3789 2020. CHEMICAL PEELS - p. 3790 2021. LASER RESURFACING - p. 3793 2022. DERMABRASION - p. 3796 2023. COMBINED RESURFACING PROCEDURES - p. 3796 2024. POSTPROCEDURE SKIN CARE - p. 3797 2025. RESURFACING COMPLICATIONS - p. 3798 2026. CONCLUSION - p. 3799 2027. 222 Management of Benign Facial Lesions - p. 3801 2028. INTRODUCTION - p. 3801 2029. HISTORY AND PHYSICAL EXAMINATION - p. 3801 2030. EPIDERMAL LESIONS - p. 3801 2031. SKIN APPENDAGE TUMORS - p. 3802 2032. NON–SKIN APPENDAGE TUMORS - p. 3805 2033. LABORATORY STUDIES - p. 3808 2034. THERAPEUTIC CONSIDERATIONS: TECHNIQUES AND INSTRUMENTATION - p. 3809 2035. TREATMENT OF SPECIFIC LESIONS - p. 3813 2036. 223 Congenital Vascular Lesions of the Head and Neck - p. 3818 2037. CLASSIFICATION AND MANAGEMENT OF CONGENITAL VASCULAR ANOMALIES - p. 3818 2038. SPECIAL CONSIDERATIONS - p. 3820 2039. VASCULAR MALFORMATIONS - p. 3825 2040. TREATMENT - p. 3828 2041. SUMMARY - p. 3838 2042. 224 Management of Alopecia - p. 3840 2043. INTRODUCTION - p. 3840 2044. MEDICAL TREATMENT OF ANDROGENIC ALOPECIA - p. 3840 2045. SURGICAL TREATMENT OF ALOPECIA - p. 3841 2046. FEMALE PATTERN HAIR LOSS - p. 3848 2047. ANESTHESIA - p. 3849 2048. AUTOGRAFT HAIR TRANSPLANTATION - p. 3849 2049. SCALP REDUCTIONS AND SCALP FLAPS - p. 3852 2050. HAIRLINE LOWERING/FOREHEAD REDUCTION SURGERY - p. 3852 2051. TISSUE EXPANSION - p. 3854 2052. HAIR TRANSPLANTATION TO THE NONSCALP - p. 3854 2053. 225 Injectables for Facial Rejuvenation - p. 3857 2054. INTRODUCTION - p. 3857 2055. APPROACH TO AGE-RELATED CHANGES TO FACIAL ANATOMY - p. 3857 2056. BOTULINUM TOXIN - p. 3859 2057. FACIAL FILLERS - p. 3864 2058. NECK CONTOURING AND CHEMICAL LIPOLYSIS - p. 3869 2059. CONCLUSION - p. 3869 2060. SECTION XI: CONTEMPORARY ISSUES IN MEDICAL PRACTICE - p. 3873 2061. 226 Patient Safety in Otolaryngology - p. 3875 2062. INTRODUCTION - p. 3875 2063. FUNDAMENTALS OF PATIENT SAFETY AND QUALITY IMPROVEMENT - p. 3875 2064. CASE 1 - p. 3878 2065. INSTITUTIONAL STRATEGIES TO ENSURE PATIENT SAFETY - p. 3879 2066. SPECIFIC QUALITY IMPROVEMENT ISSUES IN OTOLARYNGOLOGY - p. 3883 2067. CONCLUSION - p. 3884 2068. 227 Legal and Regulatory Considerations for the Otorhinolaryngologist—Head and Neck Surgeon - p. 3887 2069. INTRODUCTION - p. 3887 2070. MEDICAL MALPRACTICE - p. 3887 2071. CREDENTIALING AND PRIVILEGING - p. 3892 2072. COMPLIANCE PROGRAMS - p. 3893 2073. CONCLUSION - p. 3896 2074. 228 Coding in Otolaryngology - p. 3898 2075. HISTORY OF CODING - p. 3898 2076. CODING BASICS - p. 3899 2077. OFFICE CODING - p. 3900 2078. SURGICAL CODING - p. 3902 2079. CONCLUSION - p. 3905 2080. 229 Building a Comprehensive Outpatient Otolaryngology Practice - p. 3906 2081. INTRODUCTION - p. 3906 2082. HUMAN RESOURCES - p. 3906 2083. OFFICE EFFICIENCY - p. 3909 2084. INFORMATION TECHNOLOGY - p. 3910 2085. MARKETING - p. 3911 2086. SAFETY AND QUALITY - p. 3912 2087. PHYSICIAN EXTENDERS AND ANCILLARY SERVICES - p. 3913 2088. CONCLUSION - p. 3915 2089. 230 Databases Driving Improvement - p. 3918 2090. INTRODUCTION - p. 3918 2091. ADMINISTRATIVE DATABASES - p. 3919 2092. CLINICAL REGISTRIES - p. 3922 2093. CONCLUSION - p. 3926 2094. 231 Telemedicine for Otolaryngology - p. 3931 2095. INTRODUCTION - p. 3931 2096. DEFINITIONS - p. 3931 2097. DIRECT TO CONSUMER TECHNOLOGY - p. 3933 2098. SECURITY, HIPAA, AND THE COVID-19 PANDEMIC - p. 3934 2099. USES OF TELEMEDICINE IN OTOLARYNGOLOGY - p. 3934 2100. BARRIERS TO ADOPTION - p. 3939 2101. 232 Quality Improvement in Otolaryngology - p. 3944 2102. INTRODUCTION - p. 3944 2103. HISTORICAL BACKGROUND - p. 3944 2104. THE ROLE OF MEASUREMENT IN QI - p. 3945 2105. ORGANIZATIONS ENDORSING QUALITY MEASURES OR MEASURING QUALITY - p. 3947 2106. EXTERNAL REQUIREMENTS FOR QUALITY - p. 3948 2107. QUALITY WITHIN HEALTH CARE INSTITUTIONS AND SYSTEMS - p. 3948 2108. QUALITY AND REIMBURSEMENT - p. 3949 2109. COMPLEX SYSTEMS AND HIGH PERFORMANCE WITHIN SYSTEMS - p. 3949 2110. A PRIMER ON LOCAL QI INITIATIVES - p. 3950 2111. CONCLUSION - p. 3950 2112. 233 Conflict of Interest - p. 3952 2113. INTRODUCTION - p. 3952 2114. DEFINITION OF CONFLICT OF INTEREST - p. 3952 2115. CONFLICT OF INTEREST IN PUBLISHING - p. 3953 2116. CONFLICT OF INTEREST IN RESEARCH - p. 3956 2117. INSTITUTIONAL CONFLICT OF INTEREST - p. 3956 2118. CONFLICT OF INTEREST IN MEDICAL PRACTICE - p. 3957 2119. CONFLICT OF INTEREST IN CONTINUING MEDICAL EDUCATION - p. 3958 2120. SPECIFIC RULES GOVERNING CONFLICTS IN INDUSTRY - p. 3958 2121. BEST PRACTICES - p. 3960 2122. 234 Anatomy: Functional Etymology - p. 3963 2123. INTRODUCTION - p. 3963 2124. RHINOLOGY/SKULL BASE - p. 3963 2125. OTOLOGY - p. 3964 2126. OTHER - p. 3966 2127. 235 Individual and System Solutions for Physician/Provider Well-Being - p. 3968 2128. DEDICATION - p. 3968 2129. INTRODUCTION - p. 3968 2130. WELLNESS AND WELL-BEING - p. 3969 2131. DEFINITIONS - p. 3970 2132. PHYSICIAN SUICIDE - p. 3971 2133. CREATING CULTURE CHANGE TO NORMALIZE NEED AND ASKING FOR HELP - p. 3972 2134. MENTAL HEALTH COMPONENT - p. 3972 2135. PHYSICAL HEALTH COMPONENT - p. 3975 2136. SELF-COMPASSION - p. 3978 2137. PLAN VACATIONS, TIME AWAY, AND “MIND AWAY” TIMES - p. 3979 2138. LEARN WHAT YOU DON’T KNOW OR ARE UNCOMFORTABLE WITH - p. 3979 2139. SUMMARY - p. 3980 2140. AUTHOR’S FAVORITE QUOTES - p. 3980 2141. ACKNOWLEDGMENTS - p. 3980 2142. ADDITIONAL ACKNOWLEDGMENTS - p. 3980 2143. 236 Simulation in Otolaryngology - p. 3983 2144. INTRODUCTION - p. 3983 2145. SIMULATORS AND SIMULATIONS - p. 3983 2146. SIMULATIONS TO IMPROVE THE SKILLS OF INDIVIDUALS - p. 3987 2147. SIMULATIONS FOR TEAMS - p. 3987 2148. SIMULATION FOR SYSTEM IMPROVEMENT - p. 3987 2149. TEACHING VERSUS ASSESSMENT USING SIMULATION - p. 3989 2150. UNIQUE APPLICATIONS OF SIMULATION - p. 3990 2151. SIMULATION PROGRAM DEVELOPMENT - p. 3991 2152. FUTURE - p. 3991 2153. 237 Cognitive and Implicit Bias - p. 3993 2154. INTRODUCTION - p. 3993 2155. TO ERR IS INDEED HUMAN - p. 3993 2156. COMMON COGNITIVE HEURISTICS AND BIASES - p. 3994 2157. EFFECTS OF COGNITIVE BIASES ON HEALTH CARE - p. 3995 2158. MITIGATION OF COGNITIVE BIAS EFFECTS - p. 3996 2159. IMPLICIT BIAS - p. 3997 2160. EFFECTS OF IMPLICIT BIASES ON HEALTH CARE - p. 3997 2161. MITIGATION OF IMPLICIT BIAS EFFECTS - p. 3998 2162. CONCLUSION - p. 3998 2163. 238 Ethics in Otolaryngology - p. 4001 2164. INTRODUCTION - p. 4001 2165. HISTORICAL BACKGROUND - p. 4001 2166. ETHICAL FRAMEWORKS FOR PRACTICE - p. 4002 2167. CLINICAL ETHICS IN OTOLARYNGOLOGY - p. 4003 2168. PROFESSIONAL ETHICS IN OTOLARYNGOLOGY - p. 4007 2169. CONCLUSION - p. 4010 2170. Index - p. I-1
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