Comprehensive management of hereditary hemorrhagic telangiectasia.

Purpose Of Review: Hereditary hemorrhagic telangiectasia (HHT), or Osler Weber-Rendu disease, is a rare inherited disorder of fibrovascular tissue affecting various organs. Epistaxis is the most common symptom of HHT but as the disease affects multiple organs, a multisystem and multidisciplinary approach to management is required. The purpose of this article is to provide an overview of the multidisciplinary approach to HHT for the otolaryngologist and to discuss the current pharmacologic and procedural treatment options available for HHT-related epistaxis.

Comparing use of the Sonopet(®) ultrasonic bone aspirator to traditional instrumentation during the endoscopic transsphenoidal approach in pituitary tumor resection.

Background: The Sonopet(®) ultrasonic bone aspirator (Stryker(®) , Kalamazoo, MI) has been used within neurosurgery, otolaryngology and in other fields, but to our knowledge has not been reported in the literature for use in endoscopic transsphenoidal approaches (TSAs) to the skull base. The study objective was to compare use of the ultrasonic bone aspirator (UBA) vs traditional cold steel instrumentation during TSA in terms of operative time and blood loss.

Methods: The study design was a prospective, randomized, single-blinded controlled clinical trial.

Evidence-based practice: reflux in sinusitis.

It is now widely recognized that extraesophageal reflux (reflux reaching structures above the upper esophageal sphincter) has a wide range of effects on the upper aerodigestive tract, as well as the lungs. The degree to which this reflux contributes to the pathophysiology of sinusitis and other sinonasal diseases is still not completely clear, but an increasing body of literature supports a potential role.

Hurricane Katrina and its effects on a regional cochlear implant program.

Objective: The purpose of this study was to analyze the effects Hurricane Katrina had on the demographics and outcomes of patients receiving cochlear implantation at our institution.

Design: This was a retrospective chart review of 179 patients (190 ears) receiving cochlear implantation from January 2003 to December 2007.

Methods: Paper records and an outcome database were reviewed for analysis.

Update on the diagnosis and treatment of caustic ingestion.

Caustic ingestion is a serious medical problem with a variety of clinical presentations and a complicated clinical course. This article reviews the epidemiology and pathophysiology of caustic ingestion as well as the most current approaches to diagnosis and treatment. Finally, a recent case will be presented that highlights the difficulty this problem poses to a medical team.

The role of proteoglycans in Schwann cell/astrocyte interactions and in regeneration failure at PNS/CNS interfaces.

In the dorsal root entry zone (DREZ) peripheral sensory axons fail to regenerate past the peripheral nervous system/central nervous system (PNS/CNS) interface. Additionally, in the spinal cord, central fibers that regenerate into Schwann cell (SC) bridges can enter but do not exit at the distal Schwann cell/astrocyte (AC) boundary. At both interfaces where limited mixing of the two cell types occurs, one can observe an up-regulation of inhibitory chondroitin sulfate proteoglycans (CSPGs).