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  • 1
    Online Resource
    Online Resource
    Identification of Degenerated Murine Facial Nerves With Fluorescence Labeling After Transection Injury
    Wiley ; 2023
    In:  Otolaryngology–Head and Neck Surgery Vol. 169, No. 2 ( 2023-08), p. 234-242
    Details
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 169, No. 2 ( 2023-08), p. 234-242
    Abstract: Delayed peripheral nerve repair is complicated by nerve degeneration and atrophy that can prevent identification. We use a murine facial nerve transection model to demonstrate the efficacy of ALM‐488 (bevonescein) in labeling degenerated facial nerves with quantitative image analysis and qualitative survey data. Study Design Prospective cohort study. Setting Laboratory. Methods Ten wild‐type mice underwent transection of the lower facial nerve division with subsequent degeneration. Either 9 (n = 5 mice) or 12 (n = 5 mice) weeks later, mice underwent intravenous infusion of ALM‐488 with in vivo real‐time fluorescence imaging (FL) of the facial nerve. Using ImageJ, the mean gray value of each nerve segment under white light reflectance (WLR) and FL was compared to that of adjacent soft tissue to calculate the signal‐to‐background ratio (SBR). A survey was distributed to evaluate the perceived utility of ALM‐488 in surgeon identification of degenerated nerves. Results The mean SBR of degenerated nerves was 1.08 (standard deviation [SD]: 0.07) under WLR and 2.11 (SD: 0.31) under FL ( p   〈  0.001). In mice with degenerated nerves, survey participants identified on average 3.01 (SD: 1.84) nerve branches under WLR and 5.73 (SD: 1.88) under FL ( p   〈  0.0001). Under FL, 47 of 48 survey responses correctly identified isolated, degenerated nerves; in contrast, only 12 responses identified degenerated nerves under WLR ( p   〈  0.0001). Conclusion Preoperative intravenous infusion of ALM‐488 with FL improves the identification of degenerated facial nerves. ALM‐488 also improves surgeon confidence in nerve identification, particularly in degenerated nerve branches that are not visible with WLR.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    URL: Issue
    URL: Article
    DOI: 10.1002/ohn.v169.2
    DOI: 10.1002/ohn.262
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008453-5
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  • 2
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    Bilateral Inferior Turbinate Flaps for Salvage Reconstruction after Proton Beam Radiotherapy for Clival Chordoma
    Georg Thieme Verlag KG ; 2023
    In:  Journal of Neurological Surgery Reports Vol. 84, No. 03 ( 2023-07), p. e87-e91
    Details
    In: Journal of Neurological Surgery Reports, Georg Thieme Verlag KG, Vol. 84, No. 03 ( 2023-07), p. e87-e91
    Abstract: Clival chordoma is a rare, aggressive, notochord-derived tumor primarily managed with surgery via an endoscopic endonasal approach (EEA) and adjuvant proton beam radiotherapy. Reconstruction is commonly performed with a nasoseptal flap (NSF) at the time of initial surgery. While failures of the NSF are rare, they can occur following the initial surgery or in the setting of osteoradionecrosis. Salvage repair typically requires transfer of alternative vascularized tissues outside of the previously radiated field including regional scalp flaps such as pericranial or temporoparietal fascial flaps, or free vascularized tissue transfer. Here we describe the case of a 29-year-old woman with a history of clival chordoma with widespread skull base osteomyelitis secondary to NSF necrosis after proton beam radiotherapy. We describe successful skull base reconstruction with intranasal bilateral inferior turbinate flaps based on the sphenopalatine artery with lateral nasal wall extension, despite prior proton beam therapy and a failed prior vascularized intranasal reconstruction.
    Type of Medium: Online Resource
    ISSN: 2193-6358 , 2193-6366
    URL: Article
    DOI: 10.1055/s-0043-1772200
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2677885-3
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  • 3
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    Online Resource
    A Scoping Review of Ongoing Fluorescence‐Guided Surgery Clinical Trials in Otolaryngology
    Wiley ; 2022
    In:  The Laryngoscope Vol. 132, No. 1 ( 2022-01), p. 36-44
    Details
    In: The Laryngoscope, Wiley, Vol. 132, No. 1 ( 2022-01), p. 36-44
    Abstract: Fluorescence‐guided surgery (FGS) is a rapidly developing intraoperative technology, and many contrast agents are currently under investigation. We sought to provide a review of the current state of FGS clinical trials in Otolaryngology, emphasizing its oncologic applications. Methods According to the preferred reporting Items for systematic reviews and meta‐analyses (PRISMA) workflow for scoping reviews, a clinical trial search was performed across multiple international clinical trials registries, searching for permutations of “fluorescence,” “tumor,” “surgery,” and “nerve” to identify all relevant studies. Studies that were active, enrolling, or soon to be enrolling patients undergoing head and neck surgery were included. Results Nineteen studies were eligible for inclusion. Seventeen studies are focused on FGS for oncologic resection and lymph node detection. One study assesses peripheral nerve fluorescence, and one evaluates normal parathyroid function after thyroidectomy. Contrast agents under development are conjugated to fluorophores that excite in the 800 nm (indocyanine green), 410 nm (5‐a minolevulinic acid), 700 nm (Cyanine 5.5), and 525 nm ranges (fluorescein derivatives). Conclusion Presently, there are 19 ongoing trials investigating novel FGS contrast agents for their safety, efficacy, and utility in Otolaryngology—Head and Neck Surgery. These agents rely on unique fluorophores and absorption ranges in the near‐infrared and visible light spectra. FGS studies are expanding within Otolaryngology—Head and Neck Surgery with profound implications in oncologic surgery, lymph node detection, and anatomic and functional assessment. Laryngoscope , 132:36–44, 2022
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v132.1
    DOI: 10.1002/lary.29891
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2026089-1
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  • 4
    Online Resource
    Online Resource
    Reducing Surgical Risks in the Rhinoplasty Patient
    Elsevier BV ; 2023
    In:  Facial Plastic Surgery Clinics of North America Vol. 31, No. 2 ( 2023-05), p. 209-220
    Details
    In: Facial Plastic Surgery Clinics of North America, Elsevier BV, Vol. 31, No. 2 ( 2023-05), p. 209-220
    Type of Medium: Online Resource
    ISSN: 1064-7406
    URL: Article
    DOI: 10.1016/j.fsc.2023.01.005
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
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  • 5
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    Change in surgeon for revision rhinoplasty: The impact of patient demographics and surgical technique on patient retention
    Wiley ; 2020
    In:  Laryngoscope Investigative Otolaryngology Vol. 5, No. 6 ( 2020-12), p. 1044-1049
    Details
    In: Laryngoscope Investigative Otolaryngology, Wiley, Vol. 5, No. 6 ( 2020-12), p. 1044-1049
    Abstract: A subset of patients who require revision rhinoplasty will change surgeons for their second procedure. We sought to investigate the rate of surgeon change and identify associated predictors using a population‐based, ambulatory surgery database. Methods/study design In this retrospective review, 9172 rhinoplasty procedures over a 5‐year period were analyzed using the Healthcare Cost and Utilization Project (HCUP) Florida State Ambulatory Surgery and Services Database (SASD). We identified 380 patients who had at least two rhinoplasty procedures between 2009 and 2014. Logistic regression analysis was used to identify predictors of patients changing surgeons for their second documented rhinoplasty. Results Among the 380/8531 (4.4%) patients who underwent a revision rhinoplasty, 117/380 (30.8%) patients changed surgeons for their subsequent procedure within a 5‐year period. Multivariable logistic regression identified a lower likelihood of surgeon change in patients undergoing functional or cosmetic cartilage grafting procedures (OR 0.342, 95%CI 0.155‐0.714, P = .006) and in patients who self‐paid for their procedure (OR 0.476, 95%CI 0.225‐0.984, P = .048). One hundred twenty‐four patients underwent a cosmetic revision rhinoplasty and were twice as likely to change surgeons as those who underwent functional revision rhinoplasty (OR 2.042 95%CI 1.046‐4.050, P = .038). Time elapsed ( 〉 2 years) was positively correlated with likelihood of surgeon change (OR 1.236, 95%CI 1.153‐1.333, P   〈  .001). Conclusion In our analysis, 30.8% of patients changed surgeons for their revision rhinoplasty. Cartilage grafting at the time of index procedure and cash payment correlated with a decreased likelihood of surgeon change. Patients were more likely to change surgeons with increased time elapsed or for an aesthetic revision. Clarifying features associated with surgeon change may help improve patient satisfaction and retention.
    Type of Medium: Online Resource
    ISSN: 2378-8038 , 2378-8038
    URL: Issue
    URL: Article
    DOI: 10.1002/lio2.v5.6
    DOI: 10.1002/lio2.496
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2851702-7
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  • 6
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    Race, Income, and the Timeliness of Cleft Palate Repair in the United States
    Springer Science and Business Media LLC ; 2021
    In:  Cureus
    Details
    In: Cureus, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 2168-8184
    URL: Article
    DOI: 10.7759/cureus.13414
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2747273-5
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  • 7
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    Race and sex demographics in the surgical management of facial nerve palsy
    Wiley ; 2023
    In:  Laryngoscope Investigative Otolaryngology Vol. 8, No. 3 ( 2023-06), p. 639-644
    Details
    In: Laryngoscope Investigative Otolaryngology, Wiley, Vol. 8, No. 3 ( 2023-06), p. 639-644
    Abstract: Facial palsy affects patients of all backgrounds, yet no existing studies describe differences in its treatment patterns between demographic groups. Methods We used the National Surgical Quality Improvement Project database to investigate whether race and sex disparities exist in facial reanimation surgery. Patients were identified using CPT codes corresponding to facial‐nerve procedures. Results Seven hundred sixty‐one patients met criteria; 681 self‐identified as White (89.5%), 51 as Black (6.7%), 43 as Hispanic (5.6%), 23 as Asian (3.0%), and 5 patients as other (0.61%). White patients were more than twice as likely to undergo brow ptosis repair than Non‐White patients (OR 2.49, 95% CI 1.16–6.15, p  = .03). After controlling for malignancy, men had longer operative times than women (480.2 vs. 413.9 min, p  = .04) and higher likelihood of free tissue transfer (OR 4.1, 95% CI 1.9–9.8), fascial free tissue transfer (OR 10.7, 95% CI 2.1–195), and ectropion repair (OR 1.8, 95% CI 1.2–2.8). Conclusion Most patients undergoing facial reanimation surgery in the United States are White. Men have longer operative times and a higher likelihood of undergoing free fascial grafts and cutaneous and fascial free tissue transfer than women regardless of malignancy status. Level of Evidence 2c.
    Type of Medium: Online Resource
    ISSN: 2378-8038 , 2378-8038
    URL: Issue
    URL: Article
    DOI: 10.1002/lio2.v8.3
    DOI: 10.1002/lio2.1053
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2851702-7
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  • 8
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    Elective neck dissection for T3 / T4 cN0 sinonasal squamous cell carcinoma
    Wiley ; 2020
    In:  Head & Neck Vol. 42, No. 12 ( 2020-12), p. 3655-3662
    Details
    In: Head & Neck, Wiley, Vol. 42, No. 12 ( 2020-12), p. 3655-3662
    Abstract: In locally advanced sinonasal squamous cell carcinoma (SNSCC), management of the clinically node‐negative (cN0) neck is variable and elective neck dissection (END) remains controversial. Methods Patients with surgically treated T3/T4 cN0 M0 SNSCC were identified using the NCDB. Overall survival (OS) was assessed by Cox proportional hazard analysis in propensity score‐matched cohorts. Factors associated with END were evaluated with logistic regression. Results Two hundred twenty patients underwent END (19.6%). END did not correlated with OS in propensity score‐matched cohorts (HR 0.971, 95% CI 0.677‐1.392), a maxillary sinus tumor subgroup (HR 1.089, 95% CI 0.742‐1.599), or by radiation status [radiation: (HR 0.802, 95% CI 0.584‐1.102); no radiation: (HR 0.852, 95% CI 0.502‐1.445)]. The occult metastasis rate in the END cohort was 12.7%. Conclusion END did not significantly improve OS in this study. Further information on disease‐free survival is necessary to determine its role in advanced‐stage SNSCC.
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    URL: Article
    DOI: 10.1002/hed.v42.12
    DOI: 10.1002/hed.26418
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2001440-5
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  • 9
    Online Resource
    Online Resource
    Rate and Factors Associated With Change in Surgeon for Revision Endoscopic Sinus Surgery
    Wiley ; 2021
    In:  The Laryngoscope Vol. 131, No. 4 ( 2021-04)
    Details
    In: The Laryngoscope, Wiley, Vol. 131, No. 4 ( 2021-04)
    Abstract: A subset of patients will undergo revision endoscopic sinus surgery (ESS) with a different otolaryngologist than the one who performed their primary surgery. The purpose of this study is to report the incidence of and clinicodemographic factors associated with a change in surgeon for revision ESS. Study Design Retrospective cohort study. Methods Adult patients who underwent at least two outpatient ESS procedures between 2009 and 2014 using the State Ambulatory Surgery Database for Florida were included in the study. Change in surgeon was defined by a change in a unique provider identifier for the revision procedure. Multivariable regression analysis was used to determine characteristics associated with a change in surgeon. Results A total of 2,963 patients were included. For the revision procedure, 47.7% of patients changed their surgeon. On multivariable logistic regression, a medium‐ (odds ratio [OR]: 0.64; 95% confidence interval [CI] : 0.53‐0.77) or high‐volume (OR: 0.50; 95% CI: 0.42‐0.61) surgeon performing the index surgery and advanced age (≥65 years) (OR: 0.79; 95% CI: 0.63‐0.99) were associated with decreased odds of surgeon change for revision ESS. Longer time elapsed between index and revision surgery (OR: 1.15; 95% CI: 1.13‐1.17) was associated with increased odds of surgeon change. Conclusions Nearly half of patients who undergo revision ESS select a surgeon other than the one who performed their primary procedure. Surgeon volume, age, and time between surgeries affect the likelihood of a change in surgeon for revision ESS. These findings may provide introductory insights into patient preferences and decision making in the surgical management of recalcitrant chronic rhinosinusitis. Level of Evidence 4 Laryngoscope , 131:E1049–E1053, 2021
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v131.4
    DOI: 10.1002/lary.29012
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2026089-1
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  • 10
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    Association of subjective olfactory dysfunction and 12‐item odor identification testing in ambulatory COVID‐19 patients
    Wiley ; 2020
    In:  International Forum of Allergy & Rhinology Vol. 10, No. 11 ( 2020-11), p. 1209-1217
    Details
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 10, No. 11 ( 2020-11), p. 1209-1217
    Abstract: Acute loss of smell and taste are well‐recognized symptoms of coronavirus disease 2019 (COVID‐19), yet the correlation between self‐reported and psychophysical olfactory function remains unclear. Understanding the reliability of self‐reported smell loss in ambulatory cases can assess the utility of this screening measure. Methods A prospective, longitudinal study evaluating patient‐reported and measured olfactory function using the validated 12‐item Brief Smell Identification Test (BSIT) was conducted on adult outpatients with COVID‐19. Patient‐reported olfaction scores using a visual analog scale (VAS) were obtained at baseline, time of COVID‐19 testing, and time of BSIT completion. Linear associations between VAS and BSIT were evaluated using Spearman's correlation coefficient and the sensitivity, specificity, and accuracy of VAS scores were calculated. Logistic regression identified characteristics associated with accurate assessment of olfactory function. Results A total of 81 polymerase chain reaction (PCR)‐confirmed COVID‐19 positive subjects, of whom 54 self‐reported smell loss, were prospectively recruited ≤5 days from diagnosis date between May 8, 2020, and July 8, 2020. Self‐reported smell loss had good discriminative ability in identifying abnormal BSIT (area under receiver operating curve [AUC] 0.82, 95% confidence interval [CI] , 0.71 to 0.92). A VAS 〈 5 demonstrated sensitivity of 0.62 and specificity of 0.94 for predicting hyposmia (BSIT ≤8) with accuracy of 82.7%, whereas a VAS 〈 9 had highest sensitivity at 0.86. Moderate bivariate linear associations were found between VAS and BSIT scores ( r s = 0.59, p 〈 0.001). Conclusion Self‐reported olfactory loss associated with COVID‐19 has a strong ability to predict abnormal olfactory function though the 2 measures are moderately correlated. Subjective olfactory assessment is useful in screening olfactory dysfunction at early disease time points when psychophysical testing cannot be conducted.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    URL: Article
    DOI: 10.1002/alr.v10.11
    DOI: 10.1002/alr.22688
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2604059-1
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