Although arytenoid dislocation is reported in the literature, the body of available evidence fails to sufficiently differentiate it as a separate entity from unilateral vocal fold paralysis. Flexible laryngoscopy is inadequate as a standalone procedure to distinguish arytenoid dislocation from laryngeal nerve injury.
Patients with suspected neuropathy of the recurrent laryngeal nerve frequently respond to neuromodulator therapy. The addition of reflux precautions and acid suppression therapy is helpful in cases of chronic and recurrent laryngospasm. Patients with evidence of motor neuropathy appear to have better outcomes with neuromodulator therapy.
The concentration of bone dust produced during cortical mastoidectomy is below regulatory guidelines for use of particulate respirators. However, experimental studies show the use of a surgical respirator may decrease particulate exposure.
Physician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency. We discuss five different practice models for incorporation of advanced practice providers in an outpatient otolaryngology practice. These models include scribe, collaborative, limited independent, partial independent, and near complete independent practice and are based primarily on the autonomy level of the physician extender. In additon, we examine available literature discussing the cost effectiveness of physician extenders used in an outpatient setting.
This review presents a treatment method for subglottic cysts that is safe and effective and has a symptomatic recurrence rate lower than previously reported.
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