Menu Expand
Geriatric Otolaryngology, An Issue of Clinics in Geriatric Medicine, E-Book

Geriatric Otolaryngology, An Issue of Clinics in Geriatric Medicine, E-Book

Karen Kost

(2018)

Additional Information

Book Details

Abstract

This issue of Clinics in Geriatric Medicine, Guest Edited by Dr. Karen Kost, is devoted to Geriatric Otolaryngology. Articles in this issue include: Hearing Loss in the Elderly; Balance Disorders in the Elderly; Dysphagia in the Older Patient; The Aging Voice; Sleep-disordered Breathing; Rhinosinusitis and Allergies; Head and Neck Cancer in the Elderly; Cutaneous Malignancies; Thyroid Disorders; Anesthetic considerations in Geriatric Otolaryngology; and Frailty in Geriatric Otolaryngology.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Geriatric Otolaryngology\r i
Copyright\r ii
Contributors iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Geriatric Otolaryngology: Why It Matters v
Hearing Loss in the Elderly v
Balance Disorders in Older Adults v
Geriatric Dysphagia v
Voice Disorders in the Elderly v
Sleep Disorders in the Elderly vi
Rhinosinusitis and Allergies in Elderly Patients vi
Head and Neck Cancer in the Elderly: Frailty, Shared Decisions, and Avoidance of Low Value Care vi
Cutaneous Head and Neck Malignancies in the Elderly vi
Thyroid Disorders in the Elderly: An Overall Summary vii
Anesthesia in the Elderly Patient Undergoing Otolaryngology Head and Neck Surgery vii
Frailty and Polypharmacy in Older Patients with Otolaryngologic Diseases vii
CLINICS IN GERIATRIC MEDICINE\r viii
FORTHCOMING ISSUES viii
August 2018 viii
November 2018 viii
February 2019 viii
RECENT ISSUES viii
February 2018 viii
November 2017 viii
August 2017 viii
Preface:\rGeriatric Otolaryngology: Why It Matters ix
REFERENCES x
Hearing Loss in the Elderly 163
Key points 163
INTRODUCTION 163
PRESENTATION 164
HEARING LOSS AND COGNITION 165
MANAGEMENT 166
HEARING AIDS 166
OSSEOINTEGRATED AUDITORY IMPLANTS 166
COCHLEAR IMPLANTATION 167
REGENERATIVE THERAPIES 168
GENE THERAPY 169
PHARMACOTHERAPY 169
STEM CELLS 169
SUMMARY 169
REFERENCES 170
Balance Disorders in Older Adults 175
Key points 175
INTRODUCTION 175
FALLS 176
PHYSIOLOGY OF THE AGING VESTIBULAR SYSTEM 177
VESTIBULAR CAUSES OF BALANCE DISORDERS 177
BENIGN PAROXYSMAL POSITIONAL VERTIGO 178
MENIERE DISEASE 178
POSTLABYRINTHITIS VESTIBULOPATHY 178
POLYPHARMACY 178
EVALUATION OF THE OLDER ADULT WITH A BALANCE DISORDER 179
MANAGEMENT 180
SUMMARY 180
REFERENCES 181
Geriatric Dysphagia 183
Key points 183
INTRODUCTION 183
Normal Swallowing Function 184
Normal Swallowing in the Elderly 184
Evaluation of Swallowing in the Elderly 185
Dysphagia due to Polypharmacy 186
Treatment 186
SUMMARY 188
REFERENCES 188
Voice Disorders in the Elderly 191
Key points 191
INTRODUCTION 191
ANATOMY AND PHYSIOLOGY 192
ACOUSTIC CHANGES IN THE AGING VOICE 194
MEDICAL INTERVENTION 195
PSYCHOLOGY AND INTELLECT 197
ENDOCRINE SYSTEM 197
HEAD AND NECK 198
OTHER CONDITIONS 198
VOICE THERAPY 198
The Impact of Vocal Exercise 198
Surgery 199
SPECIAL CONSIDERATIONS: THE UNTRAINED PROFESSIONAL SINGER AND THE CHORAL SINGER 200
SUMMARY 200
REFERENCES 200
Sleep Disorders in the Elderly 205
Key points 205
INTRODUCTION 205
NORMAL PHYSIOLOGIC CHANGES IN SLEEP PATTERNS 206
COMMON SLEEP DISORDERS IN THE ELDERLY 207
Advance Sleep Phase 207
Sleep-Disordered Breathing 209
Insomnia 212
Sleep-Related Movement Disorders 214
Periodic Limb Movement 214
Rapid Eye Movement Sleep Behavior Disorder 215
SUMMARY 215
REFERENCES 215
Rhinosinusitis and Allergies in Elderly Patients 217
Key points 217
INTRODUCTION 217
Anatomic and Physiologic Changes with Age 218
Anatomy 218
Nasal mucosa 218
Viscoelastic properties of the secretions 218
Rhinitis in the Elderly 219
ALLERGIC RHINITIS 220
NONALLERGIC RHINITIS 220
Idiopathic Rhinitis, Also Known as Vasomotor Rhinitis 220
Atrophic Rhinitis 221
Drug-Induced Rhinitis 221
Gustatory Rhinitis 221
EVALUATION 221
TREATMENT 222
Allergic Rhinitis 222
Environmental management 223
Pharmacologic treatment 223
Intranasal corticosteroids 223
Antihistamines: 223
Decongestants 224
Antileukotrienes 224
Anticholinergics 224
Allergen-specific immunotherapy 224
Nonallergic Rhinitis 225
Idiopathic or vasomotor rhinitis 225
Gustatory rhinorrhea 225
Atrophic rhinitis 225
SURGERY 225
CHRONIC RHINOSINUSITIS 226
TREATMENT 226
Surgery 227
SUMMARY 227
REFERENCES 227
Head and Neck Cancer in the Elderly 233
Key points 233
INTRODUCTION 234
Survival Rates 234
Epidemiologic Trends 234
Treatment at the End of Life 234
HOW TO APPROACH THE OLDER ADULT WITH HEAD AND NECK CANCER 235
Identifying the Frail Patient 235
Guidelines to Approach Decision Making in Older Adults 236
THERAPEUTIC OPTIONS AND CONSIDERATIONS 236
Current Treatment Paradigms 236
Supportive Care 237
SHARED DECISION MAKING 237
Implementation 237
Decisional Regret 238
CLINICAL VIGNETTE 239
SUMMARY 240
REFERENCES 240
Cutaneous Head and Neck Malignancies in the Elderly 245
Key points 245
NONMELANOMA SKIN CANCER 246
Basal Cell Carcinoma 246
Squamous Cell Carcinoma 248
MERKEL CELL CARCINOMA 250
CUTANEOUS MELANOMA 252
SUMMARY 255
REFERENCES 255
Thyroid Disorders in the Elderly 259
Key points 259
INTRODUCTION 259
ANATOMIC AND PHYSIOLOGIC CHANGES 259
BIOCHEMISTRY: OVERT HYPOTHYROIDISM AND HYPERTHYROIDISM 260
THYROID NODULES: DIAGNOSIS, WORKUP, AND MANAGEMENT 263
THYROID CANCER SURGERY AND CARE PATHWAY (DEESCALATION AND EMERGING ACTIVE SURVEILLANCE) 264
Thyroid Cancer (Epidemiology) 264
SPECIFIC CONSIDERATIONS IN THE ELDERLY: POSTOPERATIVE THYROID-STIMULATING HORMONE SUPPRESSION 267
ADJUVANT THERAPY: RADIOACTIVE IODINE, EXTERNAL BEAM RADIATION, AND CHEMOTHERAPY 268
SURVEILLANCE AND MANAGEMENT OF RECURRENCE 269
SUMMARY 272
ACKNOWLEDGMENTS 272
REFERENCES 272
Anesthesia in the Elderly Patient Undergoing Otolaryngology Head and Neck Surgery 279
Key points 279
INTRODUCTION 279
PHYSIOLOGY OF AGING 280
Nervous System 280
Cardiovascular System 280
Respiratory System 280
Pharmacology 281
PERIOPERATIVE OUTCOMES IN THE ELDERLY PATIENTS 281
Mortality 281
Morbidity 281
Cardiac and pulmonary complications 281
Renal complications 281
Postoperative delirium and postoperative cognitive dysfunction 281
ANESTHETIC STRATEGIES TO IMPROVE OUTCOME IN THE ELDERLY SURGICAL PATIENTS 282
Improved Assessment of the Elderly 282
Optimizing the Geriatric Patient 282
Inhalation Versus Total Intravenous Anesthesia 283
Improved Muscle Relaxation Strategy 283
Monitored Anesthesia Care 284
SUMMARY 285
REFERENCES 285
Frailty and Polypharmacy in Older Patients with Otolaryngologic Diseases 289
Key points 289
INTRODUCTION 289
FRAILTY 290
SPECIFIC IMPLICATIONS FOR FRAILTY IN OTOLARYNGOLOGY 290
FRAILTY AND SURGICAL OUTCOMES 290
CHALLENGES OF FRAILTY ASSESSMENT IN CLINICAL SETTINGS 291
MEASURES OF FRAILTY 292
CARDIOVASCULAR HEALTH STUDY ASSESSMENT TOOL 293
MEASURES OF FRAILTY USED IN SURGICAL OUTCOMES STUDIES 293
MODIFIED FRAILTY INDEX 293
RISK ANALYSIS INDEX 293
AUTOMATED DATA EXTRACTION FROM ELECTRONIC MEDICAL RECORD 295
FRAILTY—SUMMARY 295
POLYPHARMACY 296
Balance 296
Dysphagia 296
Reflux 296
Sinusitis and Postnasal Drip 297
Summary of Polypharmacy in Otolaryngologic Diseases 297
REFERENCES 298