Otolaryngology Commons^™

Is The Use Of Intestinal Helminths Safe And Effective In The Treatment Of Allergic Rhinitis?, Tanner Mccalley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether the use of intestinal helminths is safe and effective in the treatment of allergic rhinitis.

STUDY DESIGN: Review of three English language, blinded randomized controlled trials from 2009, 2010, and 2010.

DATA SOURCE: Randomized, controlled, blinded trials comparing the use of intestinal helminths versus visually matched placebo as a treatment for allergic rhinitis found using PubMed and Ovid databases.

OUTCOMES MEASURED: Several different systems were used to evaluate the symptoms or occurrence of AR. Bager et al.2010 uses symptom scores of AR scale of 0 …

Value-Based Analysis Of Routine Pathologic Septal And Inferior Turbinate Specimens., James J Daniero, Jaemi S Chu, Brian J O'Hara, Edmund A. Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

This article was presented at the 2012 AAO-HNSF Annual Meeting & OTO EXPO; September 9-12, 2012; Washington, DC.

Objective To determine the frequency and clinical relevance of unanticipated histopathologic results in routine sinonasal surgery and evaluate the necessity for histologic processing of nasal septal cartilage, bone, and inferior turbinate specimens. Study Design Case series with chart review. Setting Tertiary care academic medical center. Subjects and Methods A retrospective review of surgical pathology reports on adult patients undergoing sinonasal surgery during a 5-year period from 2005 to 2010 was performed. All cases with the preoperative diagnosis of sinonasal neoplasia, autoimmune disease, …

Development Of Skin Hypopigmentation In A Patient With Metastatic Papillary Carcinoma Thyroid Treated With Sorafenib., Syed Zubair Hussain, Ali Asghar, Mubasher Ikram, Najmul Islam

Section of Otolaryngology, Head & Neck Surgery

Background: Sorafenib can be considered as the effective option of treatment in patients with metastatic radioiodine refractory differentiated thyroid cancers. The cutaneous manifestations of Sorafenib include rash, desquamation, hand foot skin reactions, pruritus, alopecia and erythema. We report the first case of hypopigmentation related to sorafenib therapy. Case presentation: We report the case of a middle aged gentleman with metastatic papillary carcinoma of thyroid diagnosed in 2005. He was managed with total thyroidectomy, radioactive iodine and TSH suppressive therapy. Despite receiving radioactive iodine 530 mci cumulative dose, patient had persistant disease with lung metastasis. Therefore a TKI, sorafenib, was started. …

Tuberculosis Verrucosa Cutis In A Patient With Keloid Over Ear Lobule, Muhammad Sohail Halim, Sadaf Qadeer Ahmed, Montasir Junaid, Muhammad Rizwan Bashir

Section of Otolaryngology, Head & Neck Surgery

Tuberculosis (TB) is a global health problem with predominance in resource-poor countries. Extrapulmonary TB constitutes approximately 10% of the cases and can present as different forms depending on the route of entry. Cutaneous TB is a small subset of the extrapulmonary TB. Cutaneous TB can either be of primary origin or secondary origin or it can be a part of a systemic infection. TB verrucosa cutis (TBVC) is the exogenous reinfection of TB in a previously sensitised patient. Routine cultures do not have a high yield in TBVC due to the paucibacillary nature of the organism. Here we are presenting …

Dermatofibrosarcoma Protuberans: An Unusual Case Of Neck Swelling, Naeem Sultan Ali, Maliha Kazi, Beena Umar, Mumtaz Jamshed Khan

Section of Otolaryngology, Head & Neck Surgery

Dermatofibrosarcoma protuberans (DFSP) is a relatively intermediate to low grade malignant tumour with high proclivity for local recurrence if excised inadequately. It is a locally aggressive tumour and despite sharing some histological features with fibrohistiocytic tumours, it tends to grow in a more infiltrative manner. We are reporting this rare tumour in a 30-year-old woman where the diagnosis of DFSP was confirmed histologically and by positive immunomarkers at immunohistochemistry.

Repair Of Nasal Septal Perforation With Porcine Small Intestinal Submucosa Xenograft, Jewel Greywoode, Md, James Hamilton, Md, Prashant S. Malhotra, Md, Abdel Saad, Md, Edmund A. Pribitkin, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background:

Numerous techniques have been described for nasal septal perforation repair, with various degrees of success in achieving closure. Evidence supports the use of bilateral mucoperichondrial advancement flaps with interpositional grafting for greatest success. Many surgeons use autografts such as fascia, cartilage, bone, and pericranium, however, extracellular matrices have also become popular.

Objective:

We analyze factors determining the success of nasal septal perforations repaired using using an acellular, freeze-dried interpositional xenograft derived from Porcine Small Intestinal Submucosa (PSIS).

Methods:

Patients with septal perforation repaired by the senior author from 1998 to 2006 were examined in a retrospective chart review with …

Early Adoption Of Transoral Robotic Surgical Program: Preliminary Outcomes., David Cognetti, Adam Luginbuhl, Anthony L. Nguyen, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: The objective of this study is to demonstrate the feasibility and safety of establishing a transoral robotic surgical (TORS) program in the post-Food and Drug Administration (FDA) approval setting. Early outcomes are compared with the previously reported results of pioneering centers.

STUDY DESIGN: Clinical data from a prospective TORS study.

SETTING: Academic university institution.

SUBJECTS AND METHODS: Sixty-one patients treated with 63 TORS procedures. Main outcome measures: intraoperative times, margin status, complications, time to diet, and percutaneous endoscopic gastrostomy (PEG) tube retention rate. The authors also report oncologic outcomes on their first 30 patients.

RESULTS: The spectrum of subsites …

Monocarboxylate Transporter 4 And Caveolin-1 Expression In Squamous Cell Carcinoma Of The Oral Cavity, Julie A. Ames, Md, Aileen Butera, Md, Joseph Curry, Md, Madalina Tuluc, Md, Ubaldo E. Martinez-Outshoorn, Md, Diana Whitaker-Menezes, Phd, Federica Sotgia, Phd, Michael P. Lisanti, Md, Phd

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presented at: 8th International Conference on Head and Neck Cancer in Toronto Canada, July 21-25, 2012.

Objective: To determine the significance of caveolin-1 (cav-1) and monocarboxylate transporter 4 (MCT4) in squamous cell carcinoma of the oral cavity. We hypothesized that high stromal MCT4 would predict a worse prognosis and correlate with low stromal Cav-1.

A Thermoplastic Vest To Prevent Self Mutilation In Experimental Flap Surgery In Rats, Eli A. Gordin, Md, Sarah M. Drejet, Md, Ryan N. Heffelfinger, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presented at: 8th International Conference on Head and Neck Cancer in Toronto, Canada.

Introduction:

Rats are frequently utilized for both research and training related to reconstructive head and neck surgery. The femoral neurovascular complex represents a useful mode for microvascular anastomosis, both for the purposes of testing adjuncts designed to improve anastomotic patency rates, as well as for residents and students to gain experience in microvascular surgery outside the operating room. Additionally, the rat proves useful in investigations examining the survivability of both random and axial pattern skin flaps.

A Case Of Otogenic Tetanus., Mohammad Adeel, Shaheryar Ahmed Rajput, Muhammad Sohail Awan, Asif Arain

Section of Otolaryngology, Head & Neck Surgery

The authors are presenting our experience of managing an interesting case of a 12-year-old girl who presented to our clinic with otorrhea for 3 months and trismus for 1 week. Examination showed bilateral ear discharge with central perforations in tympanic membranes, palatal paralysis and trismus. Systemic examination revealed only mild stiffness of hand muscles. CT-scan head and neck was done to look for intracranial complications of otitis media. However, it revealed only decreased pneumatisation of mastoid cells. She was admitted in the hospital and started on intravenous and local antibiotics after sending ear swab and blood cultures. But she showed …

Giant Cell Reparative Granuloma Of Temporal Bone: Case Report Of A 62-Year-Old Male, Muhammad Waqas, Naeem Sultan Ali, Muhammad Zubair Tahir, Syed Ather Enam, Zeeshan-Ud-Din, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Giant cell reparative granuloma (GCRG) is an uncommon non‑neoplastic reactive tumor which occurs almost exclusively within the mandible and maxilla. GCRG of the temporal bone is a rare condition. It has been found to affect predominantly adolescents and adults (age: 10‑25 years). We report a case of a 62‑year‑old male with GCRG of left temporal bone who presented to us with progressive left temporal swelling for 3 months. It was associated with hearing loss. There was no history of trauma. A non‑contrast computed tomography scan brain showed a locally destructive lesion involving squamous temporal bone closely related to the left …

Sinonasal Teratocarcinosarcoma, Zainul Abedeen Sobani, Shabbir Akhtar, Montasir Junaid, Iftikhar Salahuddin

Section of Otolaryngology, Head & Neck Surgery

Teratocarcinosarcoma is a rare, morphologically heterogeneous and highly malignant neoplasm. It is characterized by the presence of benign and malignant epithelial, mesenchymal and neural components. The carcinoma may be either squamous or adenocarcinoma and the mesenchymal component may manifest spindle, smooth, skeletal muscle, cartilage and bone features. Because of their infrequency, these lesions are often misdiagnosed, leading to management difficulties. In this case report we have shared our experience with sinonasal teratocarcinosarcoma in a 23 year old female and performed a brief review of literature.

Composition Of The Adult Digestive Tract Bacterial Microbiome Based On Seven Mouth Surfaces, Tonsils, Throat And Stool Samples, Nicola Segata, Susan Kinder Haake, Peter Mannon, Katherine P. Lemon, Levi Waldron, Dirk Gevers, Curtis Huttenhower, Jacques Izard

Department of Food Science and Technology: Faculty Publications

Background: To understand the relationship between our bacterial microbiome and health, it is essential to define the microbiome in the absence of disease. The digestive tract includes diverse habitats and hosts the human body’s greatest bacterial density. We describe the bacterial community composition of ten digestive tract sites from more than 200 normal adults enrolled in the Human Microbiome Project, and metagenomically determined metabolic potentials of four representative sites.

Results: The microbiota of these diverse habitats formed four groups based on similar community compositions: buccal mucosa, keratinized gingiva, hard palate; saliva, tongue, tonsils, throat; sub- and supra-gingival plaques; …

Post-Traumatic Pseudoaneurysm Of Internal Carotid Artery: A Cause Of Intractable Epistaxis., Mohammad Adeel, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

In this case report, the authors are presenting a case of a 35-year-old lady who presented to our clinic with recurrent episodes of massive epistaxis and loss of right eye vision for last 6 months following road traffic accident. There was no other significant medical and surgical history. Bleeding episodes were sometimes very severe with loss up to 400-500 cc and would stop spontaneously. She was given multiple blood transfusions after these episodes. A complete otorhinolaryngological examination including rigid endoscopy and coagulation investigation did not reveal any abnormality. CT with contrast of paranasal region showed blood within the right sphenoid …

Daycare Adeno-Tonsillectomy: Is It Safe In Developing Countries, Aria Masoom, Shabbir Akhtar, Hassan Nabeel Humayun, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To determine the safety of daycare adeno-tonsillectomy in a tertiary care centre.

METHOD: A retrospective chart review of 207 patients who had undergone tonsillectomy and/or adenoidectomy as daycare procedure in Aga Khan University Hospital, Karachi, between January 2008 to March 2009 was done. Demographic data as well as complications requiring unplanned admissions were recorded. Any emergency room visit in the first 24 hours was also noted. Telephonic calls were then made to collect the first 24-hour, postoperative data in order to know if there were any complications requiring visit to some nearby health facility. All data was analysed using …

The Rationality Of Prescribing Antibiotics After Tonsillectomy, Maqbool Ahmed Baloch, Shabbir Akhtar, Mubasher Ikram, Hassan Nabeel Humayun

Section of Otolaryngology, Head & Neck Surgery

Objective: To compare the antibiotic therapy with the absence of antibiotic therapy in reducing post-tonsillectomy morbidities
Methods: The quasi-experimental study was conducted at the Aga Khan University Hospital, Karachi, from November 2006 to September 2007. It involved 60 patients fulfilling the criteria for recurrent tonsillitis who were divided in two groups based on the different practice of two sets of surgeons. In one group antibiotics were used, while in the other group, no antibiotic was given. Patients filled a questionnaire about pain, post-operative bleeding, day of normal diet intake, day of normal activity and any consultation received during the first …

Frontal Sinus Osteoma Removal With The Ultrasonic Bone Aspirator., Eric Ehieli, Jaemi Chu, Eli Gordin, Edmund A Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Osteomas, the most common skull tumors, are typically excised through either an open or endoscopic ostectomy using a high-speed drill, a technically challenging procedure that can result in injury to adjacent soft tissue structures. Osteoma removal through ultrasonic bone emulsification and aspiration (UBA) offers the advantages of decreased blood loss, preservation of adjacent soft tissue structures, and precise bone removal. UBA was used to successfully remove a forehead osteoma without injury to adjacent nerves and with a satisfactory cosmetic outcome. We describe skull osteoma removal with an ultrasonic bone aspirator, which offers potential advantages over conventional bone removal techniques.

Frontal Sinus Osteoma Removal With The Ultrasonic Bone Aspirator., Eric Ehieli, Jaemi Chu, Eli Gordin, Edmund A. Pribitkin

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Osteomas, the most common skull tumors, are typically excised through either an open or endoscopic ostectomy using a high-speed drill, a technically challenging procedure that can result in injury to adjacent soft tissue structures. Osteoma removal through ultrasonic bone emulsification and aspiration (UBA) offers the advantages of decreased blood loss, preservation of adjacent soft tissue structures, and precise bone removal. UBA was used to successfully remove a forehead osteoma without injury to adjacent nerves and with a satisfactory cosmetic outcome. We describe skull osteoma removal with an ultrasonic bone aspirator, which offers potential advantages over conventional bone removal techniques.

Minimally Invasive Endoscopic Selective Parathyroidectomy, Montasir Junaid, Zainul Abedeen Sobani, Maliha Kazi, Mumtaz Junaid Khan

Section of Otolaryngology, Head & Neck Surgery

Primary hyperparathyroidism is a common condition with surgery being the definitive treatment modality. Controversy exists over the extent of optimal neck exploration, whether unilateral or bilateral exploration should be performed, particularly since 85-90% of primary hyperparathyroidism results from single gland disease. Unilateral neck exploration is now considered to be adequate unless a definitive adenoma is not identified on ipsilateral exploration and where the serum intact Parathyroid Hormone (iPTH) level does not show a decline greater than 60% after removal of a suspected adenoma. It also avoids the potential risk of hypocalcaemia, recurrent laryngeal nerve injury along with extended anaesthesia and …

Angioembolization In Itractable Epistaxis—A Tertiary Care Experience, Maqbool Ahmed Baloch, Mohammad Sohail Awan, Hassan Nabeel Humayun

Department of Surgery Docs

Objective: To review the role of angioembolization in the control of intractable epistaxis at our institution. Methods: A retrospective review of the charts of the patients between Jan 2001 to June 2010 at Aga Khan University Hospital, Karachi was done. All patients who underwent angioembolization for intractable epistaxis were included in the study. Patients with nasal or nasopharyngeal mass were excluded. Data was analyzed by using SPSS version 16. Results: Total numbers of the patients were 16. Fourteen (87.5%) patients were male and 2(12.5%) were female with mean age 51.2 ± 12.922 years (range 26-71 years). In 11(68.75%) patients there …