Otolaryngologic Clinics of North America

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Latest articles

Perioperative Analgesia for Sinus and Skull-Base Surgery

Perioperative analgesic management is multifaceted, and an individualized approach should be taken with each patient. Preoperative discussion of the plan for pain control and the patient’s postoperative expectations is a necessary facet for optimal outcomes of analgesia. There is the potential for significant abuse and development of dependence on opioids....

Postoperative Analgesia in the Chronic Pain Patient

An increasing number of chronic pain patients presenting for surgery are chronic opioid users. Pain management in the postoperative period can be challenging in this population due to the development of tolerance, physical dependence, and hyperalgesia in long-term opioid users. It is common for postoperative pain to be undertreated in these patients,...

Pain Psychology for Surgeons and Otolaryngologists

Pain is one of the leading reasons that brings patients into health care facilities; yet, it often is left undertreated. The biopsychosocial model of pain, which recognizes that pain is multidimensional, explains the complexities that affect the pain experience and response to treatment. Inclusion of behavioral and psychological factors in medical and...

Nonenteral Pain Management

Otolaryngologic surgeries present challenges to ensuring postoperative pain control owing to their location and nature that may require patients to be NPO for long periods of time, making enteral medication administration difficult or impossible. There are several alternative administration routes to bypass the gastrointestinal tract, including intravenous,...

Sinus Headache

The diagnosis “sinus headache” has been reclassified as “headache attributed to disorder of the nose or paranasal sinuses” by the International Headache Society, but the term is still commonly used by patients and primary care doctors alike. Rhinologic symptoms and headache disorders are common, and they may coexist without a causative relationship....

Diversity and Inclusion—Why Does It Matter

Otolaryngology has historically lagged behind other specialties with respect to diversity, equity and inclusion (DEI) and remains one of the least diverse specialties as it relates to gender, race and ethnicity. Strategies aimed at increasing DEI include programs designed to provide mentorship, coaching, and sponsorship. Pipeline efforts, inclusivity...

Controlled Substance Agreements and Other Best Opioid Prescription Practices

Controlled substance agreements between providers and patients represent important strategies for setting expectations for chronic opioid therapy. These agreements generally summarize best opioid prescription practices and destigmatize practice policies such as regular toxicology screenings. These controlled substance agreements also set expectations...

Chronic Pain Management in Head and Neck Oncology

Pain is epidemic in patients with head and neck cancer. Providers involved in the care of patients with head and neck cancer should be able to describe the common pain syndromes experienced by these patients, identify patients at risk of pain, and provide multimodal treatment of chronic pain. Treatment of chronic pain encompasses analgesic medications;...

Quality Improvement in Pain Medicine

In the last 30 years, pain control in the United States has undergone several evolutions impacting the care of surgical patients. More recently, safe pain control has been a subject of quality improvement efforts by otolaryngologists focusing on minimizing opioid consumption. This article discusses the rising overprescription of opioids, influenced...

Local Blocks and Regional Anesthesia in the Head and Neck

Local anesthesia is commonly used for head and neck procedures. Many anesthetic agents are available, with differing properties that can alter their durations of action and lengths of time to onset. These agents can be used acutely for laceration repair or as adjuncts to intravenous sedation. Local and regional anesthetic agents can also be used for...

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