Otolaryngology Commons^™

Seizures Induce Obstructive Apnea In Dba/2j Audiogenic Seizure-Prone Mice: Lifesaving Impact Of Tracheal Implants, R. Irizarry, D. Sukato, R. Kollmar, S. Schild, J. Silverman, K. Sundaram, S. Stephenson, M. Stewart

Journal Articles

Wiley Periodicals, Inc. © 2020 International League Against Epilepsy The mechanism(s) for sudden death in epilepsy (SUDEP) remain(s) unknown, but seizure spread to brainstem areas serving autonomic and respiratory function is critical. In a rat model, we established a mechanism for SUDEP that involves seizure-induced laryngospasm and obstructive apnea lasting until respiratory arrest. We hypothesized that DBA/2J mice, which display lethal audiogenic seizures, would be protected from death by implanting a tracheal T-tube as a surrogate airway. In a 2 × 2 design, mice were implanted with either open or closed tracheal T-tubes and treated with either low-dose ketamine/xylazine to …

A New Office-Based Procedure For Treatment Of Snoring: The S.I.Le.N.C.E. Study., M. Friedman, M. B. Gillespie, F. A. Shabdiz, D. H. Hiltzik, T. A. Meyer, J. Ahn, P. J. Catalano, N. J. Joseph

Journal Articles

Objective:Demonstrate the safety and effectiveness of palatal foreshortening and stiffening in reducing snoring severity in nonobstructive sleep apnea (non-OSA) patients complaining of chronic disruptive snoring. Methods:In a US-based 8-center, open-label, prospective, single-arm cohort study, 52 consenting adults with chronic disruptive snoring (snoring impacting a patient's life and causing patient or bed partner to seek medical intervention) were treated via office-based placement of resorbable, bidirectional, barbed suture implants into the soft palate under local anesthesia. Prior to intervention, home sleep tests (HSTs) were performed to rule out OSA and to document snoring noise level. Both subject and their bed/sleep partners (also …

Late Complications Of Free Flaps In Head And Neck Microvascular Reconstruction, Swapna Vasudevan, Cory Bovenzi, Md

Phase 1

Introduction: Late free flap complications (LFFC) in head and neck reconstructive surgery occur over 72 hours postoperatively and result in flap loss in 97% of cases. Due to the rarity of LFFC, there is minimal research regarding risk factors for their development. Identifying risk factors for LFFC will result in improved monitoring of patients to prevent flap loss. This study aims to identify risk factors for the development of LFFC.

Methods: The target population of this retrospective cohort study was 116 patients who had undergone an Orbital Exenteration at Thomas Jefferson University Hospital (TJUH) and had LFFC. Data was …

Eagle Syndrome Masquerading As A Chicken Bone, Jason E. Cohn, Sammy Othman, Karima Sajadi-Ernazarova

Otolaryngology (ENT) Resident Research

This is a brief report of a 17-year-old male who presented to the emergency department with odynophagia and a foreign body sensation in the throat after choking on a chicken wing. A soft tissue neck radiograph was performed which revealed a 4.6-cm linear object in the vallecula read by the radiology department as a chicken bone. The otolaryngology team was consulted and performed a nasopharyngeal laryngoscopy which did not reveal a foreign body in the upper aerodigestive tract. On physical examination, the right tonsillar fossa was tender to palpation. Upon further review of the radiograph, the right stylohyoid ligament was …

Cognitive Changes In Patients Treated For Obstructive Sleep Apnea With Upper Airway Stimulation, Maxillomandibular Advancement, Or Expansion Sphincter Pharyngoplasty, Nicolas Zingas, Colin Huntley, Matthew Stewart, Ramez Philips

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a prevalent diagnosis that has been shown to not only affect sleepiness, but daytime cognitive function — specifically attention, working memory, and executive function. CPAP treatment is troublesome for some patients and it is possible that superior treatment options, specifically novel surgical techniques, are available, though none have been evaluated for their long-term effects on neurocognition. We hypothesize that treating patients with upper airway stimulation surgery (UAS) UAS, maxillomandibular advancement surgery (MMA), and expansion sphincter pharyngoplasty surgery (ESP) for OSA produces a significant improvement in cognition from baseline.

Methods: For inclusion in the study, …

Literature-Guided Recommendations For Otolaryngologists During The Covid-19 Pandemic: A Contemporary Review, Mausumi Syamal

Otolaryngology Head & Neck Surgery Faculty Publications

Objective: The objective of this study was to review the current literature and guidelines on management of the novel coronavirus 2019 (COVID-19 or 2019nCoV) with respect to the field of Otolaryngology.

Design: Contemporary literature review.

Methods: Systematic literature review of global medical literature databases and communications were queried to find all available literature recommendations, research, and guidelines applicable to otolaryngologists in the COVID-19 pandemic.

Results: Guidance on personal protective equipment, office visits, and surgical scheduling, as well as recommendations for safe airway management and tracheotomy performance during the COVID-19 pandemic were compiled and interpreted.

Conclusion: Little guidance exists for otolaryngologists …

A Rare Case Of Bleeding Epiphrenic Esophageal Diverticulum From Arteriovenous Malformations., Franklin L. Thelmo, Harvey Guttmann, Waqas Ullah, Ahmad Arslan, Eugen Brailoiu

Abington Jefferson Health Papers

Epiphrenic esophageal diverticula (EED) is a rare condition that usually presents with dysphagia in patients with a known motility disorder. In this article, we present a unique case of EED presenting with hemoptysis with clinical workup negative for any pulmonary pathology. Esophagogastroduodenoscopy revealed arteriovenous malformations within the EED successfully managed with argon plasma coagulation (APC), leading to a resolution of the patient's symptoms.

Retrospective Review Of Fluoroscopic Swallowing Studies And Outcomes At An Academic Health Center, Rachel Strock, Priyha Mahesh, Baskaran Sundaram, Md, Gregory C. Kane, Md

Phase 1

Introduction: Aspiration is often associated with underlying medical conditions and can cause pneumonia or death. Aspiration risk can be assessed via video fluoroscopic swallowing study (VFSS) or barium swallow (BaSw). We aimed to assess the diagnoses and clinical course of patients who were evaluated for potential aspiration through VFSS or BaSw to determine if there is a degree of aspiration that increases the risk of developing pneumonia and/or death.

Methods: We conducted a retrospective chart review of 374 patients in TJUH who were evaluated via VFSS or BaSw from January 1 to June 30, 2017. We recorded the degree and …

The Impact Of The Fda Warning On Post-Tonsillectomy Opioid Prescribing In Publicly And Privately Insured Children, Dianna J. Soelberg

Theses and Dissertations

Due to reports of significant adverse events, the U.S. FDA placed a Boxed Warning on the opioid codeine in February 2013 – contraindicating its use in pediatric patients undergoing tonsillectomy and/or adenoidectomy. Studies conducted in privately insured children showed a reduction in codeine prescribing and a slight increase in alterative opioid prescribing following the FDA warning, yet the extent to which the FDA warning impacted prescribing in publicly insured children is unknown. Using a quasi-experimental interrupted time series design, this study evaluated codeine and alternative opioid prescribing before and after the FDA warning in both publicly and privately insured children …

Covid-19 Sampling From The Middle Ear And Mastoid: A Case Report, George B Wanna, Zachary G Schwam, Vivian F Kaul, Maura K Cosetti, Enrique Perez, Peter Filip, Waleed Javaid, Avi Kandel, Alberto Paniz-Mondolfi, Satish Govindaraj, Eric M Genden

Faculty, Staff and Student Publications

No abstract provided.

Microbiotyping The Sinonasal Microbiome, Ahmed Bassiouni, Sathish Paramasivan, Arron Shiffer, Matthew R Dillon, Emily K Cope, Clare Cooksley, Mahnaz Ramezanpour, Sophia Moraitis, Mohammad Javed Ali, Benjamin S Bleier, Claudio Callejas, Marjolein E Cornet, Richard G Douglas, Daniel Dutra, Christos Georgalas, Richard J Harvey, Peter H Hwang, Amber U Luong, Rodney J Schlosser, Pongsakorn Tantilipikorn, Marc A Tewfik, Sarah Vreugde, Peter-John Wormald, J Gregory Caporaso, Alkis J Psaltis

Faculty, Staff and Student Publications

This study offers a novel description of the sinonasal microbiome, through an unsupervised machine learning approach combining dimensionality reduction and clustering. We apply our method to the International Sinonasal Microbiome Study (ISMS) dataset of 410 sinus swab samples. We propose three main sinonasal “microbiotypes” or “states”: the first is Corynebacterium-dominated, the second is Staphylococcus-dominated, and the third dominated by the other core genera of the sinonasal microbiome (Streptococcus, Haemophilus, Moraxella, and Pseudomonas). The prevalence of the three microbiotypes studied did not differ between healthy and diseased sinuses, but differences in their distribution were evident based …

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery Docs

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …