Virtual reality can reduce anxiety during office-based great saphenous vein radiofrequency ablation.

Objective: Office-based treatment of venous pathology is common and frequently involves the use of anxiolytic medication to reduce anxiety. Virtual reality (VR) has been shown to effectively reduce pain and anxiety in a variety of settings. The objective of the present study was to determine whether VR could be smoothly integrated into office-based vascular procedures and to ascertain whether VR could reduce procedural pain or anxiety.

Mid-infrared laser orbital septal tightening: ex vivo dosimetry study and pilot clinical study.

Importance: Blepharoplasty is one of the most commonly performed facial aesthetic surgeries. While myriad techniques exist to improve the appearance of the lower eyelids, there is no clear consensus on the optimal management of the orbital septum.

Objectives: To evaluate the safety and feasibility of the use of the holmium:yttrium aluminum garnet (Ho:YAG) laser for orbital septal tightening, and to determine whether modest use of this laser would provide some degree of clinical efficacy.

Threshold of visual perception of facial asymmetry in a facial paralysis model.

Objective: To determine the degree of facial asymmetry required to trigger conscious perception in the observer in a simulated model of facial paralysis.

Methods: A model of unilateral facial paralysis was created using the face of a participant without facial paralysis. Digital morphing software was used to create progressive asymmetry of the brow, oral commissure, and combined brow and oral commissure based on the typical sequelae seen in facial paralysis.

Adult nasal dermoid sinus cyst.

Midline congenital nasal lesions are rarely encountered in adults. We present the case of a 31-year-old man with a nasal dermoid sinus cyst who presented with a nasal dorsal abscess. We review the embryology of nasal dermoid sinus cysts, and we discuss their presentation, evaluation, and management in adults.

Combined endoscopic and transoral resection of a primary nasopharyngeal paraganglioma.

We present what to the best of our knowledge is only the fourth case of a primary nasopharyngeal paraganglioma to be reported in the literature, and we describe a novel surgical approach to its removal. The patient was a 53-year-old woman who presented with a nasopharyngeal mass. A subtotal resection and biopsy of the mass identified it as a paraganglioma.

Local flaps I: bilobed, rhombic, and cervicofacial.

This article is the first in a series focusing on the reconstruction of defects of the head and neck created by the resection of a skin cancer. This series begins with a detailed description of specific types of local flaps, and is followed by articles emphasizing the options for reconstruction by anatomic site. The surgical technique for three workhorse flaps of the face are described: the bilobed flap, rhombic flap, and cervicofacial flaps.

Surgical treatment of dysthyroid orbitopathy.

Objectives: Orbital decompression for dysthyroid orbitopathy may be performed by open or transnasal endoscopic approaches; however, criteria for the selection of the appropriate surgical technique have not been well-defined. Our goal was to compare the surgical outcomes of orbital decompression techniques employed by the otolaryngology and ophthalmology services at a single institution, so as to clarify the indications and develop a rationale for optimal management.

Study Design: Case series with chart review.

Selective endoscopic decompression of the orbital apex for dysthyroid optic neuropathy.

Objectives/hypothesis: To introduce the concept of selective endoscopic decompression of the orbital apex for dysthyroid optic neuropathy and present surgical outcomes.

Study Design: Prospective case series.

Methods: Consecutive patients undergoing urgent endoscopic orbital apex decompression for dysthyroid optic neuropathy were studied prospectively.

Nasopharyngeal carcinoma: the role of the Epstein-Barr virus.

Nasopharyngeal carcinoma (NPC) arises from the epithelium of the nasopharynx and is a rare tumor in most parts of the world, including the United States. Neck swelling, nasal obstruction, and epistaxis are the most common presenting symptoms. The etiology of NPC is multifactorial and includes genetic susceptibility, exposure to carcinogens, and prior infection with the Epstein-Barr virus (EBV).

Laryngeal cancer: diagnosis and preoperative work-up.

Laryngeal carcinoma is the eleventh-most common form of cancer among men worldwide and is the second-most common malignancy of the head and neck. The primary functions of the larynx involve phonation, respiration, and deglutition but it also contributes to taste and smell by allowing the movement of air over the special sense organs. Thus, loss of laryngeal function affects speech and swallowing and some of the senses that allow us to enjoy the world.

Treatment considerations in facial paralysis.

Facial nerve paralysis and its sequelae are devastating to patients. For the reconstructive surgeon, the management of the patient with facial paralysis is challenging. There is a lack of consensus regarding the initial management.

The artificial tympanic membrane (1840-1910): from brilliant innovation to quack device.

Objective: To present the rich and checkered history of the artificial eardrum, a widely used device in the 19th century, and to illustrate the behavior of otologists in response to the introduction of a promising new technology.

Data Sources: Over 40 published books and articles spanning the years 1821 to 1909 in English, German, and French. DEVICE DESCRIPTIONS: A wide variety of devices were used to improve hearing and, purportedly, to reduce aural discharge.