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Book Details
Abstract
This issue of Physician Assistant Clinics, guest edited by Laura A. Kirk, MSPAS, PA-C, is devoted to Otolaryngology. Articles in this issue include: Hyperparathyroidism: Workup and Treatment; "Sinus" Headaches: Sinusitis vs. Migraine; Sudden Sensorineural Hearing Loss; ENT Manifestations of Sarcoidosis; Pediatric Otitis Media; Evaluation and Management of Adult Neck Masses; Vestibular Migraine; Pediatric Sleep Disordered Breathing; Benign Paroxysmal Positional Vertigo (BPPV); Infectious and Inflammatory Salivary Disease; Evaluation and Management of Pediatric Neck Masses: An Otolaryngology Perspective; and Indications for Cochlear Implantation.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Otolaryngology | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITOR | v | ||
| AUTHORS | v | ||
| Contents | vii | ||
| Foreword: New Year Resolutions | vii | ||
| Preface: Otolaryngology: A Selection of Diverse and Relevant Topics for Primary Care | vii | ||
| Benign Paroxysmal Positional Vertigo: State-of-the-“Art” Diagnosis and Treatment | vii | ||
| Vestibular Migraine: Diagnostic Criteria and Treatment Options | vii | ||
| “Sinus” Headaches: Sinusitis Versus Migraine | vii | ||
| Pediatric Sleep-Disordered Breathing | viii | ||
| Pediatric Otitis Media: An Update | viii | ||
| Cochlear Implants in the Elderly: Recognizing a Frequently Missed Demographic of Surgical Candidates for Hearing Restoration | viii | ||
| Sudden Sensorineural Loss in Primary Care: An Often-Missed Diagnosis | viii | ||
| Evaluation and Management of Pediatric Neck Masses: An Otolaryngology Perspective | ix | ||
| Evaluation and Management of Adult Neck Masses | ix | ||
| Ear, Nose, and Throat Manifestations of Sarcoidosis | ix | ||
| Primary Hyperparathyroidism | ix | ||
| PHYSICIAN ASSISTANT CLINICS\r\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| July 2018 | xi | ||
| October 2018 | xi | ||
| January 2019 | xi | ||
| RECENT ISSUES | xi | ||
| January 2018 | xi | ||
| October 2017 | xi | ||
| July 2017 | xi | ||
| Foreword: New Year Resolutions\r | xiii | ||
| Preface;\rOtolaryngology: A Selection of Diverse and Relevant Topics for Primary Care | xv | ||
| Benign Paroxysmal Positional Vertigo | 149 | ||
| Key points | 149 | ||
| PATHOPHYSIOLOGY | 149 | ||
| PATHOGENESIS OF BENIGN PAROXYSMAL POSITIONAL VERTIGO | 150 | ||
| DIAGNOSIS OF BENIGN PAROXYSMAL POSITIONAL VERTIGO | 151 | ||
| PHYSICAL EXAMINATION | 152 | ||
| Posterior Canal Benign Paroxysmal Positional Vertigo | 152 | ||
| Lateral (Horizontal) Canal Benign Paroxysmal Positional Vertigo | 153 | ||
| TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO | 154 | ||
| TREATMENT OF POSTERIOR CANAL BENIGN PAROXYSMAL POSITIONAL VERTIGO | 155 | ||
| Canalith Repositioning Maneuver (Epley Maneuver) | 156 | ||
| TREATMENT OF LATERAL CANAL BENIGN PAROXYSMAL POSITIONAL VERTIGO | 158 | ||
| Gufoni Maneuver for Geotropic Lateral Canal Benign Paroxysmal Positional Vertigo | 159 | ||
| BENIGN PAROXYSMAL POSITIONAL VERTIGO TREATMENT FOLLOW-UP | 160 | ||
| AMERICAN ACADEMY OF OTOLARYNGOLOGY–HEAD AND NECK SURGERY’S 2017 RECOMMENDATIONS | 160 | ||
| SUMMARY | 161 | ||
| REFERENCES | 161 | ||
| Vestibular Migraine | 163 | ||
| Key points | 163 | ||
| INTRODUCTION | 163 | ||
| History of Vestibular Migraine | 163 | ||
| Diagnostic Criteria | 164 | ||
| Pathophysiology | 165 | ||
| Incidence and Demographics | 166 | ||
| Making the Diagnosis and Testing | 167 | ||
| TREATMENT | 168 | ||
| ABORTIVE THERAPY | 169 | ||
| Triptans | 169 | ||
| PROPHYLACTIC | 170 | ||
| Anticonvulsants | 170 | ||
| Tricyclic Antidepressants | 170 | ||
| Beta-Blockers | 171 | ||
| Valproic Acid | 171 | ||
| Other Pharmaceuticals | 171 | ||
| Supplements | 171 | ||
| NONPHARMACOLOGIC | 171 | ||
| Vestibular Physical Therapy | 171 | ||
| Self-Care Techniques | 172 | ||
| Diet Modification | 172 | ||
| SUMMARY | 172 | ||
| REFERENCES | 177 | ||
| “Sinus” Headaches | 181 | ||
| Key points | 181 | ||
| “SINUS” AS A PRIMARY COMPLAINT | 181 | ||
| SYMPTOMS OF “SINUS” AND DIAGNOSTIC CRITERIA FOR ACUTE BACTERIAL RHINOSINUSITIS | 182 | ||
| SYMPTOMS OF “SINUS” AND DIAGNOSTIC CRITERIA FOR CHRONIC RHINOSINUSITIS | 182 | ||
| CAUSES OF SINUS PAIN | 183 | ||
| THE TRIGEMINOCERVICAL COMPLEX | 183 | ||
| “SINUS” HEADACHES AS MIGRAINE | 185 | ||
| COMPUTED TOMOGRAPHY SCANS AND RADIOLOGIC FINDINGS | 185 | ||
| TREATMENT OF ACUTE BACTERIAL RHINOSINUSITIS | 187 | ||
| TREATMENT OF CHRONIC RHINOSINUSITIS | 189 | ||
| TREATMENT OF “SINUS” MIGRAINE | 189 | ||
| SUMMARY | 190 | ||
| REFERENCES | 190 | ||
| Pediatric Sleep-Disordered Breathing | 193 | ||
| Key points | 193 | ||
| INTRODUCTION | 193 | ||
| SLEEP-DISORDERED BREATHING DEFINED | 194 | ||
| IMPACT OF SLEEP-DISORDERED BREATHING | 194 | ||
| Behavior | 194 | ||
| Cognition | 195 | ||
| Enuresis | 195 | ||
| Weight Disorders: Failure to Thrive | 195 | ||
| Weight Disorders: Obesity | 195 | ||
| Cariopulmonary Sequelae | 196 | ||
| Quality of Life | 196 | ||
| SLEEP-DISORDERED BREATHING: EVALUATION | 196 | ||
| History | 196 | ||
| Physical Examination | 197 | ||
| Diagnosis with Polysomnography | 198 | ||
| Clinical Decision Making - Clinical Practice Guidelines | 200 | ||
| Treatments of Sleep-Disordered Breathing | 202 | ||
| Tonsillectomy | 202 | ||
| Surgical techniques for adenotonsillectomy | 202 | ||
| Other treatment modalities | 203 | ||
| SUMMARY | 204 | ||
| ACKNOWLEDGMENTS | 204 | ||
| REFERENCES | 204 | ||
| Pediatric Otitis Media | 207 | ||
| Key points | 207 | ||
| INTRODUCTION | 207 | ||
| TERMINOLOGY | 208 | ||
| ANATOMY OF A CHILDHOOD EPIDEMIC | 209 | ||
| RISK FACTORS | 209 | ||
| EPIDEMIOLOGY OF OTITIS MEDIA | 210 | ||
| IMPACT AT HOME | 210 | ||
| OTOLOGIC IMPACT | 210 | ||
| HEALTH CARE BURDEN | 211 | ||
| CLINICAL PRACTICE GUIDELINES TO GUIDE EVIDENCE-BASED CARE | 211 | ||
| DIFFERENTIATION BETWEEN OTITIS MEDIAS: OTOSCOPY | 211 | ||
| DIFFERENTIATION BETWEEN OTITIS MEDIAS: PNEUMATIC OTOSCOPY | 213 | ||
| BARRIERS TO EVALUATION | 213 | ||
| OTITIS MEDIA WITH EFFUSION | 214 | ||
| Diagnosis of Otitis Media with Effusion | 214 | ||
| Otitis Media with Effusion in At-risk Children | 214 | ||
| Observation of Otitis Media with Effusion | 214 | ||
| Medical Therapy for Otitis Media with Effusion | 215 | ||
| Further Interventions for Otitis Media with Effusion | 215 | ||
| Tympanostomy Tubes | 215 | ||
| Risks and Complications of Pressure Equalization Tubes | 215 | ||
| Indications for Pressure Equalization Tubes in Otitis Media with Effusion | 217 | ||
| ACUTE OTITIS MEDIA | 217 | ||
| Diagnosis of Acute Otitis Media | 217 | ||
| Management of the Pain of Acute Otitis Media | 217 | ||
| Antibiotic Therapy for Acute Otitis Media | 218 | ||
| Management of Recurrent Acute Otitis Media | 218 | ||
| Indications for Tympanostomy Tubes in Acute Otitis Media | 219 | ||
| Therapy for Otitis Media: Future Directions for Research | 219 | ||
| SUMMARY | 219 | ||
| REFERENCES | 219 | ||
| Cochlear Implants in the Elderly | 223 | ||
| Key points | 223 | ||
| HEARING LOSS: AN OVERVIEW | 223 | ||
| SENSORINEURAL HEARING LOSS AND THE ELDERLY POPULATION | 224 | ||
| TRADITIONAL AMPLIFICATION WITH HEARING AIDS | 225 | ||
| AURAL REHABILITATION THROUGH COCHLEAR IMPLANTATION | 226 | ||
| COCHLEAR IMPLANTATION: SURGERY AND REHABILITATION | 226 | ||
| INDICATIONS AND CRITERIA FOR COCHLEAR IMPLANTATION | 228 | ||
| THE BENEFITS OF COCHLEAR IMPLANTATION IN THE ELDERLY POPULATION | 230 | ||
| PATIENT EDUCATION: HEARING LOSS AND TREATMENT OPTIONS | 230 | ||
| AREAS FOR FUTURE RESEARCH | 232 | ||
| SUMMARY | 232 | ||
| REFERENCES | 232 | ||
| Sudden Sensorineural Loss in Primary Care | 235 | ||
| Key points | 235 | ||
| INTRODUCTION: A CASE OF SUDDEN HEARING LOSS | 235 | ||
| SUDDEN HEARING LOSS DEFINED | 236 | ||
| HISTORY | 236 | ||
| PHYSICAL EXAMINATION | 237 | ||
| TUNING FORK TESTING | 237 | ||
| Weber Test | 237 | ||
| Rinne Test | 238 | ||
| HUM TEST | 238 | ||
| LABORATORY TESTING | 238 | ||
| TREATMENT: URGENT | 239 | ||
| ORAL STEROID THERAPY | 240 | ||
| REFERRAL FOR SPECIALTY CARE | 240 | ||
| INTRATYMPANIC STEROID THERAPY | 240 | ||
| Prognosis | 243 | ||
| SUMMARY | 243 | ||
| REFERENCES | 243 | ||
| Evaluation and Management of Pediatric Neck Masses | 245 | ||
| Key points | 245 | ||
| INTRODUCTION | 245 | ||
| HISTORY | 245 | ||
| PHYSICAL EXAMINATION AND MASS IDENTIFICATION | 246 | ||
| Mass Location | 246 | ||
| Comprehensive Head and Neck Examination | 247 | ||
| DIAGNOSTIC TESTING | 247 | ||
| Laboratory Tests | 247 | ||
| Imaging | 247 | ||
| EMBRYOLOGY | 248 | ||
| Branchial Apparatus | 248 | ||
| CONGENITAL NECK MASSES | 248 | ||
| Central Congenital Neck Masses | 248 | ||
| Thyroglossal duct cysts | 248 | ||
| Dermoid and epidermoid cysts | 249 | ||
| Plunging ranula | 250 | ||
| Midline cervical clefts | 252 | ||
| LATERAL CONGENITAL NECK MASSES | 252 | ||
| Branchial Cleft Anomalies | 252 | ||
| First Branchial Cleft Anomalies | 252 | ||
| Second Branchial Cleft Anomalies | 253 | ||
| Third and Fourth Branchial Cleft Anomalies | 253 | ||
| Management of Branchial Cleft Anomalies | 254 | ||
| Imaging of Branchial Cleft Anomalies | 254 | ||
| Torticollis | 255 | ||
| Thymic Cysts | 255 | ||
| Laryngocele | 256 | ||
| CENTRAL AND/OR LATERAL CONGENITAL NECK MASSES | 257 | ||
| Vascular Anomalies | 257 | ||
| Hemangiomas | 257 | ||
| Infantile hemangiomas | 258 | ||
| Congenital hemangiomas | 258 | ||
| Vascular Malformations | 259 | ||
| Arteriovenous malformations | 260 | ||
| Capillary malformations | 260 | ||
| Venous malformations | 261 | ||
| Lymphatic malformation | 261 | ||
| Fetal Cervical Lesions | 262 | ||
| Fetal lymphatic malformations | 262 | ||
| Fetal cervical teratomas | 262 | ||
| INFECTIOUS AND INFLAMMATORY NECK MASSES | 262 | ||
| Acute Infectious and Inflammatory Neck Masses | 262 | ||
| Cervical lymphadenitis | 262 | ||
| Chronic Infectious and Inflammatory Neck Masses | 263 | ||
| Atypical mycobacterial infection | 263 | ||
| Toxoplasmosis | 263 | ||
| Bartonella | 263 | ||
| Human immunodeficiency virus | 264 | ||
| Tick-Borne Illnesses | 264 | ||
| Lyme disease | 264 | ||
| Ehrlichiosis and Rocky Mountain Spotted Fever | 264 | ||
| NEOPLASTIC NECK MASSES | 265 | ||
| Benign Neck Neoplasms | 265 | ||
| Pilomatrixoma | 265 | ||
| Lipomas | 265 | ||
| Neural tumors | 266 | ||
| MALIGNANT NECK NEOPLASMS AND METASTATIC LYMPHADENOPATHY | 266 | ||
| Nasopharyngeal Carcinoma | 266 | ||
| Lymphoma | 266 | ||
| Neuroblastoma | 267 | ||
| Rhabdomyosarcoma | 267 | ||
| Thyroid Malignancy | 267 | ||
| Posttransplant Lymphoproliferative Disorder | 267 | ||
| OTHER | 268 | ||
| SUMMARY | 268 | ||
| ACKNOWLEDGMENTS | 268 | ||
| REFERENCES | 268 | ||
| Evaluation and Management of Adult Neck Masses | 271 | ||
| Key points | 271 | ||
| ANATOMY | 271 | ||
| PATIENT PRESENTATION | 274 | ||
| EXAMINATION | 274 | ||
| DIAGNOSTIC WORKUP | 275 | ||
| CATEGORIZATION AND PREVALENCE | 276 | ||
| NEOPLASTIC NECK MASSES | 277 | ||
| MALIGNANT NEOPLASMS | 277 | ||
| Metastatic Squamous Cell Carcinoma | 277 | ||
| Other Metastatic Cervical Lymphadenopathy | 278 | ||
| Lymphoma | 278 | ||
| Thyroid Cancer | 279 | ||
| Salivary Gland Cancer | 279 | ||
| BENIGN NEOPLASMS | 279 | ||
| Thyroid Nodules and Thyroid Goiter | 279 | ||
| Salivary Gland Masses | 280 | ||
| Paraganglioma | 280 | ||
| Lipoma | 280 | ||
| INFECTIOUS/INFLAMMATORY NECK MASSES | 280 | ||
| Viral Lymphadenopathy | 281 | ||
| Bacterial Lymphadenitis | 281 | ||
| Granulomatous Diseases | 281 | ||
| Inflammatory | 282 | ||
| CONGENITAL NECK MASSES | 282 | ||
| Vascular Malformations | 282 | ||
| Thyroglossal Duct Cysts | 282 | ||
| Branchial Cleft Cysts | 283 | ||
| Ranula | 283 | ||
| SUMMARY | 283 | ||
| REFERENCES | 283 | ||
| Ear, Nose, and Throat Manifestations of Sarcoidosis | 285 | ||
| Key points | 285 | ||
| INTRODUCTION | 285 | ||
| CASE STUDY | 286 | ||
| BACKGROUND | 286 | ||
| EPIDEMIOLOGY AND ETIOLOGY | 287 | ||
| PATHOPHYSIOLOGY | 288 | ||
| SIGNS AND SYMPTOMS | 288 | ||
| DIAGNOSIS | 289 | ||
| EAR, NOSE, AND THROAT MANIFESTATIONS | 290 | ||
| CERVICAL LYMPH NODES | 290 | ||
| LARYNX | 291 | ||
| SINONASAL | 291 | ||
| SALIVARY | 291 | ||
| OTOLOGIC | 292 | ||
| OCULAR | 292 | ||
| PITUITARY GLAND | 293 | ||
| SUMMARY | 293 | ||
| REFERENCES | 293 | ||
| Primary Hyperparathyroidism | 297 | ||
| Key points | 297 | ||
| INTRODUCTION | 297 | ||
| PARATHYROID EMBRYOLOGY AND ANATOMY | 297 | ||
| CALCIUM REGULATION AND PARATHYROID PHYSIOLOGY | 298 | ||
| Parathyroid Hormone Action on Bone | 298 | ||
| Parathyroid Hormone Action on the Kidney | 299 | ||
| Parathyroid Hormone, Vitamin D, and Action on the Intestine | 300 | ||
| PRIMARY HYPERPARATHYROIDISM | 300 | ||
| Diagnosis | 301 | ||
| Differential Diagnosis of Hypercalcemia | 301 | ||
| Manifestations of Primary Hyperparathyroidism | 301 | ||
| Bone | 303 | ||
| Kidney | 303 | ||
| Cardiovascular | 304 | ||
| Neurocognitive | 304 | ||
| SURGICAL INDICATIONS | 304 | ||
| Increased Serum Calcium Level | 304 | ||
| Bone Compromise | 304 | ||
| Renal Manifestations | 304 | ||
| Cardiovascular Abnormalities | 305 | ||
| Neurocognitive Compromise | 305 | ||
| MEDICAL MANAGEMENT | 305 | ||
| SURGICAL INTERVENTION | 306 | ||
| Localization Studies | 306 | ||
| Sestamibi | 306 | ||
| Ultrasonography | 307 | ||
| Four-dimensional computed tomography | 307 | ||
| INTRAOPERATIVE TECHNIQUES | 309 | ||
| Intraoperative Parathyroid Hormone Assay | 309 | ||
| Radioguided Surgery | 309 | ||
| Pathologic Evaluation | 309 | ||
| OBSERVATION WITHOUT SURGERY | 309 | ||
| SUMMARY | 310 | ||
| REFERENCES | 310 |