The FDA granted regenerative medicine advanced therapy designation to tisagenlecleucel for an investigational new indication to treat patients with relapsed or refractory follicular lymphoma. (Source: CancerNetwork)
During the COVID-19 pandemic, oncology teams have had to begin adopting new ways of practicing while simultaneously optimizing treatment and care, potentially leading to permanent changes in oncology services. (Source: CancerNetwork)
The FDA approved ibrutinib in combination with rituximab for the initial treatment of adult patients with chronic lymphocytic leukemia/small lymphocytic lymphoma. (Source: CancerNetwork)
Tinnitus is the perception of sound in the absence of an external source. Genetic studies on families, twins, and adoptees cohorts have been conducted supporting tinnitus heritability, with higher heritability in men with bilateral tinnitus at any age, and young women with bilateral tinnitus, but not in unilateral tinnitus. The condition is associated with several comorbidities such as hearing loss, Meniere disease, sleep disorders, depression, and migraine and may lead toward suicidal attempts in...
Device-based clinical treatments for tinnitus are predominantly sound based and include ear-level sound generators, hearing aids, cochlear implants, and tinnitus treatment devices. They are intended for patients with bothersome tinnitus. Bothersome tinnitus is characterized by problems with sleep, concentration, and mood. Most people with bothersome tinnitus have hearing loss and would benefit from amplification; however, not all patients are willing to use hearing aids. Tinnitus treatment devices...
This article focuses on the role of skeletal surgery within the modified Stanford protocol with particular attention focused on the evolved role of MMA. First, surgery in patients presenting with congenital dentofacial deformity or characteristic drug-induced sleep endoscopy findings, then the growing role of maxillary expansion in a newly identified patient phenotype, and finally genioglossus advancement, are discussed. Less commonly used and validated techniques, such as isolated mandibular advancement...
The search for an effective medication that will eliminate tinnitus has a long history. Currently, no drugs exist that universally cure tinnitus. Pharmacologic interventions that have been investigated can be divided into those that attempt to eliminate the perception of tinnitus, and those that are designed to treat the negative comorbidities associated with tinnitus, thereby mitigating tinnitus’ negative impact on quality of life. A third category of drugs can also be considered that addresses...
Obstructive sleep apnea (OSA) is a multisystem breathing disorder associated with increased morbidity and mortality. Clinical and operative assessment tools improve surgical approaches to treat airway obstruction. The primary sites of anatomic obstruction are at the levels of the nasal, palatal, and hypopharyngeal airway. The literature suggests a relationship between reduced neuromuscular tone and the age-related increase in OSA prevalence for normal-weight adults. Pharyngeal soft tissue collapse...
Tinnitus distress results from a weave of physical and psychological processes. Reducing the power of the psychological processes will therefore reduce the degree of suffering. The main psychological therapy in this context is cognitive behavioral therapy (CBT). This seeks to understand and change the influence of thinking processes, including information processing biases, and the behaviors that these motivate, on the experience of tinnitus. The results of systematic reviews and meta-analyses indicate...
Tinnitus is commonly experienced by military Service Members and Veterans, especially by the newest generation who served in Iraq and Afghanistan. When patients seek health care for tinnitus, it is important to determine its type, check for comorbid conditions that might be triggering or exacerbating the condition, and to address its functional and psychosocial effects. Otolaryngologists are usually the first health care professional to evaluate a patient with tinnitus, and it is essential to provide...
The results showed a trend of increased post-gap amplitudes and reduced gap salience; however, the small number of articles yield and limited consensus prohibit any conclusions for clinical use. Nevertheless, gap-induced EPs may be further explored as a potential tool for tinnitus detection.
Obstructive sleep apnea is a common, but under-recognized, condition. Polysomnography remains the gold standard for diagnosing obstructive sleep apnea and determining whether treatment is appropriate. The development of home sleep apnea testing has allowed for a faster and more convenient method of diagnosis. Continuous positive airway pressure is the therapy of choice for most patients with obstructive sleep apnea, but otorhinolaryngologists can expect to see more and more patients looking for alternative...
Tinnitus is the perception of a self-generated sound and an individual’s psychological reaction to it. This article discusses one element of the reaction: depression. Epidemiologic studies have noted high comorbidity of tinnitus and depression. Findings from recent brain imaging studies have noted shared neural networks in depression and severe tinnitus. As further evidence of this overlaps, antidepressants, counseling, and psychology-based approaches have been used to treat tinnitus. Multifaceted...
Obstructive sleep apnea (OSA) syndrome is a destructive and insidious entity mostly underdiagnosed and undertreated. It affects not only individuals but the society as a whole. The costs to the populations can be measured not only in morbidity and mortality but also in the financial wellbeing of a society. Financial burden of this disease is staggering. The social fabric of society is also greatly impacted. Physiologic effects of OSA are far reaching. It has been shown that early intervention with...
Hypoglossal nerve stimulation (HNS) therapy represents a novel approach and a paradigm shift in the evolution of obstructive sleep apnea (OSA) treatment as a hybrid surgically implanted, medically titratable device. Unlike traditional sleep apnea surgical procedures, HNS augments the neuromuscular activity of the pharynx, preserves upper airway structure and function, and has the potential to provide multilevel upper airway improvement with one procedure. The early success of HNS sets the stage for...
A strong association exists between excess weight and obstructive sleep apnea (OSA), and most patients with OSA have elevated body mass index. Weight loss is an essential part of treatment for patients with OSA and overweight or obesity. Lifestyle interventions are cornerstones of weight management. However, most patients have difficulty achieving and maintaining clinically significant weight loss with lifestyle interventions alone. Health care providers who treat patients with OSA should be familiar...
Retroglossal collapse is commonly seen in patients with obstructive sleep apnea. The role of upper airway stimulation surgery for these patients continues to evolve. However, base of tongue reduction surgery continues to have usefulness for appropriately selected patients with obstructive sleep apnea. Specific tongue base approaches may vary in response to patient and surgeon preferences and be used in multilevel surgery where appropriate. Key factors include patient age, willingness to undergo device...
Despite recent, major steps forward in our understanding of tinnitus pathophysiology and improved research methodology, tinnitus remains a clear unmet clinical need. Here, the authors identify current active clinical and preclinical development programs of tinnitus drug candidates using publications, databases, and company communications. The current drug development programs hold promise for new therapeutic options for tinnitus patients, but further fundamental research is needed to validate additional...
Successful palatopharyngoplasty is critical for successful sleep apnea surgery. Traditional uvulopalatopharyngoplasty was primarily excisional, whereas newer techniques, such as expansion sphincterpharyngoplasty, are more reconstructive. Studies of flow dynamics even demonstrate that the effectiveness of maxillofacial surgery is significantly mediated through stiffening and enlargement of the lateral retropalatal and pharyngeal airway. The current modified technique of uvulopalatopharyngoplasty/expansion...
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