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Cummings Otolaryngology - Head and Neck Surgery E-Book

Cummings Otolaryngology - Head and Neck Surgery E-Book

Paul W. Flint | Bruce H. Haughey | K. Thomas Robbins | J. Regan Thomas | John K. Niparko | Valerie J. Lund | Marci M. Lesperance


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Book Details


Now in its 6th edition, Cummings Otolaryngology remains the world's most detailed and trusted source for superb guidance on all facets of head and neck surgery. Completely updated with the latest minimally invasive procedures, new clinical photographs, and line drawings, this latest edition equips you to implement all the newest discoveries, techniques, and technologies that are shaping patient outcomes. Be certain with expert, dependable, accurate answers for every stage of your career from the most comprehensive, multi-disciplinary text in the field!

  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
  • Overcome virtually any clinical challenge with detailed, expert coverage of every area of head and neck surgery, authored by hundreds of leading luminaries in the field.
  • Experience clinical scenarios with vivid clarity through a heavily illustrated, full-color format which includes approximately 3,200 images and over 40 high quality procedural videos.
  • Get truly diverse perspectives and worldwide best practices from a multi-disciplinary team of contributors and editors comprised of the world’s leading experts.
  • Glean all essential, up-to-date, need-to-know information. All chapters have been meticulously updated; several extensively revised with new images, references, and content.
  • Stay at the forefront of your field with the most updated information on minimally-invasive surgical approaches to the entire skull base, vestibular implants and vestibular management involving intratympanic and physical therapy-based approaches, radiosurgical treatment of posterior fossa and skull base neoplasms, and intraoperative monitoring of cranial nerve and CNS function.
  • Apply the latest treatment options in pediatric care with new chapters on pediatric sleep disorders, pediatric infectious disease, and evaluation and management of the infant airway.
  • Find what you need faster through a streamlined format, reorganized chapters, and a color design that expedites reference.
  • Manage many of the most common disorders with treatment options derived from their genetic basis.
  • Assess real-world effectiveness and costs associated with emergent technologies and surgical approaches introduced to OHNS over the past 10 years.
  • Incorporate recent findings about endoscopic, microscopic, laser, surgically-implantable, radiosurgical, neurophysiological monitoring, MR- and CT-imaging, and other timely topics that now define contemporary operative OHNS.

Table of Contents

Section Title Page Action Price
Vol. I Vol. 1_Cover
Front cover Vol. 1_Cover
IFC_Vol.1 IFC1
Half title page Vol-1-i
Contents Breakdown Vol-1-ii
Cummings Otolaryngology Vol-1-iii
Copyright page Vol-1-iv
In Memoriam Vol-1-v
Contributors Vol-1-vii
Preface Vol-1-xxix
Acknowledgments Vol-1-xxxi
Table of Contents Vol-1-xxxiii
Video Contents Vol-1-xl
I Measuring Outcomes and Performance 1
1 Outcomes Research 3
Key Points 3
History 3
Key Terms and Concepts 4
Bias and Confounding 4
Assessment of Baseline 4
Definition of Disease. 4
Disease Severity. 4
Comorbidity. 4
Assessment of Treatment 4
Control Groups. 4
Assessment of Outcomes 5
Efficacy. 5
Effectiveness. 5
Fundamentals of Study Design 5
Randomized Trial 5
Observational Study 5
Case-Control Study 6
Case Series and Expert Opinion 6
Other Study Designs 6
Grading of Evidence-Based Medicine Recommendations 6
Measurement of Clinical Outcomes 6
Psychometric Validation 6
Categories of Outcomes 7
Examples of Outcomes Measures 7
Generic Scales 7
Disease-Specific Scales 7
Head and Neck Cancer. 7
Otologic Disease. 8
Rhinologic Disease. 8
Pediatric Diseases. 8
Voice. 8
Sleep. 9
Symptom Scales 9
Summary and Future Directions 9
Suggested Readings 9
References 9.e1
2 Interpreting Medical Data 10
Key Points 10
Seven Habits of Highly Effective Data Users 10
Habit 1: Check Quality before Quantity 10
Habit 2: Describe before You Analyze 13
Habit 3: Accept the Uncertainty of All Data 15
Habit 4: Measure Error with the Right Statistical Test 16
Habit 5: Put Clinical Importance before Statistical Significance 17
Habit 6: Seek the Sample Source 19
Habit 7: View Science as a Cumulative Process 20
Popular Statistical Tests Used by Otolaryngologists 22
t Test 22
Vol. II Vol. 2_Cover
Front cover Vol. 2_Cover
Half title page Vol-2-i
Contents Breakdown Vol-2-ii
Cummings Otolaryngology Vol-2-iii
Copyright page Vol-2-iv
In Memoriam Vol-2-v
Contributors Vol-2-vii
Preface Vol-2-xxix
Acknowledgments Vol-2-xxxi
Table of Contents Vol-2-xxxiii
Video Contents Vol-2-xl
VI Head and Neck Surgery and Oncology 1051
1 General Considerations 1053
73 Fundamentals of Molecular Biology and Gene Therapy 1053
Key Points 1053
Fundamentals of Molecular Biology 1053
Gene Expression 1053
Cell Division 1054
Gene Therapy 1055
Replacing Defective Genes 1055
Enhancing Gene Expression 1055
Suppressing Gene Expression 1055
Somatic Versus Germ Cell Gene Therapy 1056
Permanent Versus Temporary Gene Therapy 1057
Methods of Delivering Gene Therapy 1057
Direct Injection of Genetic Material 1057
DNA-Mediated Transfer of Therapeutic Genes 1057
Direct Delivery of RNA for Gene Silencing 1058
Viral-Mediated Gene Transfer 1059
Retroviruses 1059
Adenoviruses 1059
Adeno-Associated Virus 1060
Optimizing Gene Delivery with Tissue Engineering 1060
Strategies for Administering Gene Therapy 1061
Ex Vivo Gene Therapy 1061
In Vivo Gene Therapy 1062
Therapeutic Levels of Gene Expression 1062
Why Gene Therapy? 1062
New Therapeutic Approach 1062
Site-Specific Gene Expression 1063
Improved Efficacy and Safety 1063
Improved Routes of Administration and Compliance 1063
Preventive Medicine and a Reduction in Health Care Costs 1063
Applications of Somatic Gene Therapy in Otolaryngology 1063
Inherited Disease 1063
Head and Neck Oncology 1063
Immune Modulation Approaches 1063
Genetic Modification of Tumor-Infiltrating Lymphocytes 1063
Direct In Vivo Stimulation of an Antitumor Immune Response 1064
Suicide Gene Therapy 1064
Gene Augmentation Strategies 1065
Modifying Oncogenes and Tumor Suppressor Genes 1065
Inhibiting Angiogenesis 1065
Gene Suppression Strategies 1066
Gene Silencing 1066
Oncolytic Viruses 1066
Conditionally Replicating Adenovirus Therapy 1066
Plastic and Reconstructive Surgery 1067
Reconstructive Tissue Flaps and Wound Healing 1067
Repair and Regeneration of Irradiated Tissue 1068
Applications in Laryngology 1068
Applications in Otology and Neurotology 1068
Conclusion 1069
Suggested Readings 1069
References 1069.e1
74 Molecular Biology of Head and Neck Cancer 1070
Key Points 1070
Background 1070
Tumor Suppressor Genes 1071
TP53 1071
CDKN2A 1072
Oncogenes 1072
Epidermal Growth Factor Receptor 1072
Epidermal Growth Factor Receptor Pathway 1072
Clinical Implications 1073
Cetuximab 1073
Epidermal Growth Factor Receptor Resistance 1073
Tyrosine Kinase Inhibitors 1073
Conclusions 1074
Ras, Raf/MEK/ERK, and PIK/Akt/mTOR 1074
Sequencing Alterations 1075
NOTCH1 1075
Genomics and Expression Microarrays in Head and Neck Squamous Cell Carcinoma 1076
Proteomics 1077
Epigenetics 1077
DNA Methylation 1077
CDKN2A 1077
MGMT 1078
DAPK1 1078
E-cadherin 1078
Other Genes 1078
Histone Modification 1078
Micro RNAs 1079
Oncogenic Micro RNAs 1079
Tumor Suppressor Micro RNAs 1079
Clinical Implications 1079
Applications of Epigenetic Alterations 1079
Human Papillomavirus 1080
Human Papillomavirus Background and Mechanisms of Oncogenesis 1081
Cancer Stem Cells 1081
Conclusion 1082
Selected Readings 1082
References 1082.e1
75 Human Papillomavirus and the Epidemiology of Head and Neck Cancer 1083
Key Points 1083
Epidemiology of Oral Human Papillomavirus Infection 1083
Epidemiology of Human Papillomavirus–Positive Oropharyngeal Squamous Cell Cancers 1084
Incidence 1084
Site 1084
Clinical Characteristics 1084
Demographics 1084
Risk Factor Profile 1084
Treatment Considerations 1085
High-Risk Subgroups 1085
Epidermal Growth Factor Receptor 1086
Deintensification Strategies 1086
Surgery 1086
Future Directions 1087
Suggested Readings 1087
References 1087.e1
76 Radiotherapy for Head and Neck Cancer: 1088
Key Points 1088
Basic Physics 1089
Characteristics of Radiation 1089
Radiation Production by Radioactive Decay 1090
Radiation Production from Linear Accelerators 1090
Interaction of X-Rays with Matter 1090
Coherent Scattering. 1091
Photoelectric Effect. 1091
Compton Effect. 1091
Pair Production. 1091
Photodisintegration. 1091
Deposition of Dose 1091
Deposition of Energy 1091
Radiation in Conventional Medicine 1092
Linear Accelerators 1092
Particle Beams 1093
Treatment Aspects of External Beam Radiation 1093
Treatment Planning 1094
Radiobiology 1095
Cell-Cycle Arrest 1095
Mitotic Death 1095
Radiosensitivity 1095
Cell Survival 1096
Tissue-Radiation Characterizations 1097
Clinical Applications 1098
Radiation Fractionation 1098
Altered Fractionation Schedules. 1098
Radiosensitizers 1099
Reducing Hypoxia. 1099
Concomitant Chemotherapy. 1100
Unresectable Tumors. 1100
Induction Chemotherapy. 1100
Organ Preservation. 1101
Postoperative Treatment. 1101
Targeted Therapy. 1102
Advanced Radiation Technologies 1102
Intensity-Modulated Radiotherapy 1103
Intensity-Modulated Radiotherapy in Head and Neck Cancer 1103
Defining the Target: Imaging 1103
Selection and Outlining of the Targets 1104
Target Definitions in the Head and Neck. 1104
Selection and Delineation of the Lymphatic Clinical Target Volumes. 1104
Planning Target Volumes. 1104
Optimization Process: Number and Directions of the Beams. 1104
Clinical Results 1104
Nasopharynx. 1105
Paranasal Sinuses. 1105
Oropharynx. 1105
Larynx and Hypopharynx. 1106
Proton Therapy 1106
Neutron and Carbon Ion Therapy 1106
Imaging-Guided Radiotherapy 1106
Tracking Anatomic Changes During Therapy 1106
Brachytherapy 1106
Radiation Side Effects 1107
Acute Side Effects 1107
Dermatitis 1107
Vol. III Vol. 3_Cover
Front cover Vol. 3_Cover
Half title page Vol-3-i
Contents Breakdown Vol-3-ii
Cummings Otolaryngology Vol-3-iii
Copyright page Vol-3-iv
In Memoriam Vol-3-v
Contributors Vol-3-vii
Preface Vol-3-xxix
Acknowledgments Vol-3-xxxi
Table of Contents Vol-3-xxxiii
Video Contents Vol-3-xl
VII Otology, Neurotology, and Skull Base Surgery 2234
5 Inner Ear 2234
146 Cochlear Transduction and the Molecular Basis of Auditory Pathology 2234
Key Points 2234
Passive Cochlear Mechanics 2235
Physical Dimensions 2247
The Traveling Wave 2248
Active Cochlear Mechanics 2250
Role of Outer Hair Cells in Active Mechanics 2251
Prestin (SLC26A5) is Essential for Outer Hair Cell Motility and Active Transduction 2252
Conversion of Basilar Membrane Displacement to Radial Shearing Forces 2253
Radial Displacement Patterns of the Basilar Membrane 2254
Tectorial Membrane Pathophysiology 2255
Hair Cell Transduction 2257
Hair Cell Stereocilia 2258
Hair Bundle Deflections and Receptor Potentials 2258
Hair Cell Transduction Channels 2260
Transduction Channel Ion Selectivity 2261
Gating of Transduction Channels 2261
Composition of Stereocilia 2262
Defects in Cytoskeletal Proteins Lead to Deafness 2263
Dynamic Regulation of Stereocilia Length 2264
Interstereociliary Linkages 2265
Myosin VI 2266
Adaptation of Mechanoelectrical Transduction Currents 2267
Effects of Deficiencies of Other Hair Cell Channels on Hearing 2268
Defects in Hair Cell–Afferent Dendrite Synapses Lead to Deafness 2269
Auditory Neuropathy 2270
Perilymphatic-Endolymphatic Barrier 2270
Endolymph Homeostasis 2270
Summary 2273
Acknowledgments 2273
Suggested Readings 2273
References 2274.e1
147 Genetics of Ear Disorders 2275
Key Points 2275
The Genome 2275
DNA Structure and the Genetic Code 2276
Gene Structure and Expression 2276
Molecular Basis of Patterns of Inheritance 2276
Chromosomal Disorders 2277
Aneuploidies 2277
Chromosomal Rearrangements 2278
Single-Gene Disorders 2278
Dominant Disorders 2278
Recessive Disorders 2279
Penetrance and Expressivity 2280
Oligogenic Disorders 2281
X-Linkage 2281
Sporadic Cases 2281
Mitochondrial Disorders 2281
Complex Traits 2281
Genetic Heterogeneity 2282
Testing Human DNA 2282
Polymerase Chain Reaction 2282
Nucleic Acid Hybridization and Southern Blotting 2282
DNA Chips 2282
Mutation Testing 2282
Ethical Issues 2284
Utility of Molecular Genetics in Otolaryngology 2284
Suggested Readings 2284
References 2284.e1
148 Genetic Sensorineural Hearing Loss 2285
Key Points 2285
Background 2285
Classification of Hearing Impairment 2285
Diagnosis of Hearing Impairment 2286
Epidemiology of Hearing Impairment 2286
Historic Background of Genetics 2287
Fundamentals of Genetics 2287
Patterns of Inheritance 2287
Autosomal Dominant 2287
Autosomal Recessive 2288
X-Linked Inheritance 2288
Mitochondrial Inheritance 2288
Genetic Hearing Impairment 2288
Nonsyndromic Hearing Impairment 2288
Autosomal-Recessive Nonsyndromic Hearing Impairment 2289
DFNB1. 2289
Autosomal-Dominant Nonsyndromic Hearing Impairment 2290
DFNA2 (High-Frequency Hearing Loss). 2290
DFNA8/12 and DFNA13 (Midfrequency Hearing Loss). 2291
DFNA6/14/38 (Low-Frequency Hearing Loss). 2292
X-Linked Nonsyndromic Hearing Impairment 2293
Mitochondrial Nonsyndromic Hearing Impairment 2293
Syndromic Hearing Impairment 2293
Autosomal-Dominant Syndromic Hearing Impairment 2293
Branchio-oto-renal Syndrome 2293
Neurofibromatosis Type 2 2294
Stickler Syndrome 2295
Waardenburg Syndrome 2295
Treacher Collins Syndrome 2295
Autosomal-Recessive Syndromic Hearing Impairment 2295
Pendred Syndrome 2295
Jervell and Lange-Nielsen Syndrome 2296
Usher Syndromes 2296
Biotinidase Deficiency 2296
Refsum Disease 2296
X-Linked Syndromes 2296
Alport Syndrome 2296
Mohr-Tranebjaerg Syndrome 2297
Mitochondrial Syndromes 2297
Patient Management 2297
Diagnosis 2297
Genetic Testing 2298
Prenatal Testing 2298
Treatment 2299
Prevention of Hearing Impairment 2299
Cultural Considerations 2299
Acknowledgment 2299
Suggested Readings 2299
References 2300.e1
149 Otologic Manifestations of Systemic Disease 2301
Key Points 2301
Granulomatous and Infectious Diseases 2301
Langerhans Cell Histiocytosis 2301
Otologic Manifestations 2302
Tuberculosis 2303
Wegener Granulomatosis 2304
Otologic Manifestations 2305
Sarcoidosis 2305
Otologic Manifestations 2306
Syphilis 2306
Lyme Disease 2307
Otologic Manifestations 2307
Mycotic Diseases 2307
Otologic Manifestations 2308
Cytomegalic Inclusion Disease 2308
Neoplastic Diseases 2308
Multiple Myeloma 2308
Otologic Manifestations 2309
Leukemia 2309
Lymphoma 2310
Metastatic Neoplasms 2310
Diseases of the Bone 2310
Paget Disease 2311
Otologic Manifestations 2311
Osteogenesis Imperfecta 2312
Otologic Manifestations 2312
Fibrous Dysplasia 2313