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Daher GS, Kocharyan A, Carlson ML, Dillon WP, Fischbein NJ, Jackler R, Rassner U, Gurgel RK. MRI Safety of Stapes Prostheses: A Systematic Review. Otol Neurotol 2024; 45:469-474. [PMID: 38518765 DOI: 10.1097/mao.0000000000004170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
OBJECTIVE To assess magnetic resonance imaging (MRI) safety of stapes prostheses. DATA SOURCES Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from inception to November 2021 following PRISMA guidelines. REVIEW METHODS Studies reporting evidence of stapes prosthesis displacement or interaction in adult or pediatric implant recipients undergoing MRI. Cadaveric, animal, and basic studies with nonhuman data were also included. RESULTS From an initial search of 123 articles, 42 full-text studies were evaluated for eligibility and 19 studies that met the inclusion criteria were included. Motion artifact was reported in a few stainless steel prosthesis types in vitro; however, such displacement was not observed in human cadaver temporal bone studies and had no adverse reported outcomes. A small subgroup of patients in the 1980s received a ferromagnetic stainless steel stapes implant that was recalled and has not been used since 1987. Patients with implants performed in the 1980s should be directed to 1.5T scanners from an abundance of caution. CONCLUSION Modern (post-1987) stapes prostheses do not pose a risk in vivo when exposed to the magnetic fields of MRI scanners.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - William P Dillon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | | | - Robert Jackler
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Ulrich Rassner
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah
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Khandalavala KR, Marinelli JP, Lohse CM, Daher GS, Kocharyan A, Neff BA, Van Gompel JJ, Driscoll CLW, Celda MP, Link MJ, Carlson ML. Natural History of Serviceable Hearing During Active Surveillance of Nongrowing Sporadic Vestibular Schwannoma Supports Consideration of Initial Wait-and-Scan Management. Otol Neurotol 2024; 45:e42-e48. [PMID: 38085766 DOI: 10.1097/mao.0000000000004051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE The treatment paradigm of vestibular schwannoma (VS) focuses on preservation of neurologic function, with small tumors increasingly managed with active surveillance. Often, tumor size and hearing outcomes are poorly correlated. The aim of the current work was to describe the natural history of hearing among patients with nongrowing VS during observational management. STUDY DESIGN Historical cohort study. PATIENTS Adults with sporadic VS. INTERVENTION Wait-and-scan management. MAIN OUTCOME MEASURE Maintenance of serviceable hearing (SH) after diagnosis. RESULTS Among 228 patients with nongrowing VS, 157 patients had SH at diagnosis. Rates of maintaining SH (95% CI; number still at risk) at 1, 3, and 5 years after diagnosis were 94% (89-98; 118), 81% (74-89; 65), and 78% (71-87; 42), respectively. Poorer hearing at diagnosis (hazard ratio [HR] per 10 dB hearing level increase in pure-tone average of 2.51, p < 0.001; HR per 10% decrease in word recognition score of 1.70, p = 0.001) was associated with increased likelihood of developing non-SH during observation. When controlling for baseline hearing status, tumors measuring 5 mm or greater in the internal auditory canal or with cerebellopontine angle extension were associated with significantly increased risk of developing non-SH (HR, 4.87; p = 0.03). At 5 years after diagnosis, 95% of patients with nongrowing intracanalicular VS measuring less than 5 mm maintained SH. CONCLUSIONS Hearing worsens during periods of nongrowth in sporadic VS. Patients with small (<5 mm) intracanalicular tumors demonstrate robust maintenance of SH over time, reinforcing the consideration of initial observation in this patient subset.
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Affiliation(s)
- Karl R Khandalavala
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | | | - Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Graves JP, Daher GS, Bauman MMJ, Moore EJ, Tasche KK, Price DL, Van Abel KM. Association of sarcopenia with oncologic outcomes of primary treatment among patients with oral cavity cancer: A systematic review and meta-analysis. Oral Oncol 2023; 147:106608. [PMID: 37897858 DOI: 10.1016/j.oraloncology.2023.106608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
GOAL We performed a systematic review of the literature and meta-analysis to determine how radiographic sarcopenia assessment methods and the presence of pre-treatment sarcopenia impact oncologic outcomes in patients with oral cavity cancer. INTRODUCTION Pre-treatment sarcopenia has been associated with poor outcomes in many different malignancies, including head and neck cancers. However, the impact sarcopenia has on outcomes for oral cavity cancer patients is not well understood. RESULTS Twelve studies met our inclusion criteria, totaling 1007 patients. 359 (36%) of these patients were reported as sarcopenic. The most commonly utilized sarcopenia assessment methods were L3 skeletal muscle index (n = 5) and C3 skeletal muscle index to estimate L3 skeletal muscle index (n = 5). The majority of studies established their sarcopenia cutoffs as the lowest quartile skeletal muscle index in their patient cohorts. Five studies were included in our meta-analysis, totaling 251 sarcopenic and 537 non-sarcopenic patients. Compared to non-sarcopenic patients, sarcopenic patients were found to have significantly poorer overall survival (univariate: HR = 2.24, 95% CI: 1.71-2.93, I2 = 0%; multivariate: HR = 1.93, 95% CI: 1.47-2.52, I2 = 0%) and disease-free survival (univariate: HR = 2.10, 95% CI: 1.50-2.92, I2 = 0%; multivariate: HR = 1.79, 95% CI: 1.29-2.47, I2 = 10%). CONCLUSIONS Over one-third of oral cavity cancer patients may present with sarcopenia. Pre-treatment sarcopenia is associated with significantly worse overall and disease-free survival.
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Affiliation(s)
- Jeffrey P Graves
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Eric J Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kendall K Tasche
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Daniel L Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA.
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Ziai K, Agarwal A, Daher GS, Saadi RA, Lighthall JG. Facial Paralysis Referral Patterns to a Multidisciplinary Facial Nerve Clinic. Facial Plast Surg Aesthet Med 2023; 25:440-441. [PMID: 36724306 DOI: 10.1089/fpsam.2022.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Kasra Ziai
- Department of Otolaryngology - Head and Neck Surgery, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Aarti Agarwal
- Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ghazal S Daher
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Robert A Saadi
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for medical sciences, Little Rock, Arkansas, USA
| | - Jessyka G Lighthall
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
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Daher GS, Kocharyan A, Dillon MT, Carlson ML. Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otol Neurotol 2023; 44:297-309. [PMID: 36791341 DOI: 10.1097/mao.0000000000003833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To assess spatial hearing, tinnitus, and quality-of-life outcomes in adults with single-sided deafness (SSD) who underwent cochlear implantation. DATABASES REVIEWED PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from January 2008 to September 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Studies reporting spatial hearing, tinnitus, and quality-of-life outcomes in adult cochlear implant (CI) recipients (≥18 yr old) with SSD were evaluated. Study characteristics, demographic data, spatial hearing (speech recognition in noise, sound source localization), tinnitus (severity, loudness), and quality-of-life outcomes were collected. RESULTS From an initial search of 1,147 articles, 36 studies that evaluated CI use in 796 unique adults with SSD (51.3 ± 12.4 yr of age at time of implantation) were included. The mean duration of deafness was 6.2 ± 9.6 years. There was evidence of improvement for speech recognition in noise using different target-to-masker spatial configurations, with the largest benefit observed for target-to-masker configurations assessing head shadow (mean, 1.87-6.2 dB signal-to-noise ratio). Sound source localization, quantified as root-mean-squared error, improved with CI use (mean difference [MD], -25.3 degrees; 95% confidence interval [95% CI], -35.9 to -14.6 degrees; p < 0.001). Also, CI users reported a significant reduction in tinnitus severity as measured with the Tinnitus Handicap Inventory (MD, -29.97; 95% CI, -43.9 to -16.1; p < 0.001) and an improvement in spatial hearing abilities as measured with the Spatial, Speech, and Qualities of Hearing questionnaire (MD, 2.3; 95% CI, 1.7 to 2.8; p < 0.001). CONCLUSIONS Cochlear implantation and CI use consistently offer improvements in speech recognition in noise, sound source localization, tinnitus, and perceived quality of life in adults with SSD.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Moroco AE, Daher GS, O'Connell Ferster AP, Lighthall JG. Prevalence of Body Dysmorphic Disorder in an Otolaryngology-Head and Neck Surgery Clinic. Ann Otol Rhinol Laryngol 2022:34894221118772. [PMID: 35962596 DOI: 10.1177/00034894221118772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the prevalence of body dysmorphic disorder (BDD) in a general otolaryngology population presenting to an outpatient clinic. STUDY DESIGN Prospective prevalence study. SETTING Single tertiary academic otolaryngology clinic. SUBJECT AND METHODS New patients over 18 years of age who presented to an academic otolaryngology clinic between August 2018 and May 2021 completed a questionnaire including demographic questions and the validated Body Dysmorphic Disorder Questionnaire (BDDQ). Data collected from the questionnaires were analyzed to assess demographics and prevalence of BDD in an otolaryngology clinic. RESULTS Of the 242 patients queried, 15 patients screened positive for BDD. The screened prevalence of BDD was determined to be 6.2%. None of the patients had previously been diagnosed with BDD. The prevalence of prior mental health diagnoses was 34.3%. These patients had initially presented for a variety of otolaryngologic concerns and had pre-existing diagnoses of anxiety, depression, obsessive-compulsive, bipolar and eating disorders. CONCLUSION The prevalence of BDD in our population of new patients presenting to an academic otolaryngology practice (6.2%) is higher than that of the general population (1.9%).
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Affiliation(s)
- Annie E Moroco
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Ghazal S Daher
- The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | | | - Jessyka G Lighthall
- Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
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Sauer AB, Daher GS, Lohse CM, Glasgow AE, Habermann EB, Douse DM, Moore EJ, Ighodaro ET, Van Abel KM, Yin LX. Underreporting and Underrepresentation of Race and Ethnicity in Head and Neck Cancer Trials, 2010-2020: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2022; 148:662-669. [PMID: 35653143 DOI: 10.1001/jamaoto.2022.1028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There is substantial evidence demonstrating racial disparities in the survival outcomes of patients with head and neck cancer. The reporting and representation of race and ethnicity in cancer trials is crucial for generalizability of trial results to patient care and reduction of racial health disparities in head and neck cancers. Racial disparities in oncologic outcomes across various therapeutic interventions may only manifest when diverse races are appropriately represented in trials. Objective To characterize the reporting and representation of race and ethnicity in head and neck cancer clinical trials. Evidence Review A systematic search of published trials and those available on ClinicalTrials.gov was conducted to identify 3973 studies from 2010 to 2020. Title, abstract, and full-text review yielded 155 trials for data extraction of patient demographics. Year of publication, type of intervention, publication source, and funding source were also collected. Race and ethnicity data were compared with Surveillance, Epidemiology, and End Results (SEER) Program cancer registry data. Findings Of the 155 included studies, only 89 (57%) reported race or ethnicity. Only 81 (52%) of the studies reported detailed classification of race or ethnicity per the US Census Bureau classification scheme. Race and ethnicity reporting varied considerably with year of publication, type of intervention, data source, and funding source. Studies in the latter half of the decade were more likely to report race or ethnicity (odds ratio, 2.78; 95% CI, 1.33-5.80), with the highest number in 2019 (24 of 30 [80%] trials), followed by 2020 (20 of 29 [69%] trials). Among the possible interventions, trials on therapeutic chemoradiation most frequently reported race or ethnicity (11 of 12 [92%]), followed by supportive drug trials (22 of 31 [71%]), and then therapeutic chemotherapy trials (28 of 48 [58%]). When compared with SEER data, race and ethnicity distribution in clinical trials showed fewer Black patients (10% vs 8%) and Asian or Pacific Islander patients (6% vs 2%). Conclusions and Relevance In this systematic review, nearly half of head and neck cancer trials in the past decade did not report the race or ethnicity of participants. Participation of Black and Asian or Pacific Islander patients does not adequately reflect the US population's head and neck cancer demographics, limiting the generalizability of trial results and adding to racial health disparities in patients with head and neck cancers.
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Affiliation(s)
- Adam B Sauer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Amy E Glasgow
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Elizabeth B Habermann
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Dontre' M Douse
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Eric J Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Linda X Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Patel SD, Daher GS, Engle L, Zhu J, Slonimsky G. Adult tonsillectomy: An evaluation of indications and complications. Am J Otolaryngol 2022; 43:103403. [PMID: 35210109 DOI: 10.1016/j.amjoto.2022.103403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/13/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to evaluate current adult tonsillectomy indications along with risk factors associated with postoperative complications. METHODS In this retrospective chart review, demographic, clinical, and surgical data were collected from 2004 to 2020 of adult patients who underwent tonsillectomy. Indications for surgery were categorized as infectious etiology, biopsy, obstructive sleep apnea (OSA), and tonsillar stones. Data regarding postoperative hemorrhage, emergency department (ED) visits, and readmissions were collected. Multivariable logistic regression models were used to evaluate factors associated with postoperative complications. RESULTS 574 adults (mean age 32 years, 69.9% F vs. 30.1% M) were included. The most common indication was infections (62.2%), followed by biopsy (26.5%), tonsillar stones (6.8%), and OSA (4.5%). The highest frequency of postoperative bleeds (17.9%) occurred in the tonsillar stones cohort; however, the indication for surgery was not a significant predictor on multivariate analysis. Male sex and younger age were independent predictors of postoperative bleeding, while younger age was a significant predictor of postoperative ED visits. There was a significant linear trend of an increasing proportion of tonsillectomies performed for tonsillar stones compared to other indications for 2011-2019. CONCLUSION Infectious etiology was the most common indication for tonsillectomy. Indication for surgery was not a significant predictor of postoperative bleeding; however, male sex and younger age had higher odds of postoperative bleeding. The proportion of tonsillectomies performed for tonsillar stones was steadily increasing.
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Daher GS, Ziai K, Saadi RA, Pool C, Lighthall JG. Cost Analysis of Cadaveric Versus Autologous Costal Cartilage Grafting in Septorhinoplasty. Facial Plast Surg Aesthet Med 2022; 24:489-490. [DOI: 10.1089/fpsam.2021.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ghazal S. Daher
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Kasra Ziai
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Robert A. Saadi
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Christopher Pool
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Jessyka G. Lighthall
- Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
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Kocharyan A, Daher GS, Nassiri AM, Khandalavala KR, Saoji AA, Van Gompel JJ, Carlson ML. Intraoperative Use of Electrical Stapedius Reflex Testing for Cochlear Nerve Monitoring During Simultaneous Translabyrinthine Resection of Vestibular Schwannoma and Cochlear Implantation. Otol Neurotol 2022; 43:506-511. [PMID: 35195569 DOI: 10.1097/mao.0000000000003505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report the novel use of intraoperative electrically evoked stapedial reflex (eSR) for cochlear nerve monitoring during simultaneous translabyrinthine resection of vestibular schwannoma (VS) and cochlear implantation. STUDY DESIGN Clinical capsule report with video demonstration. SETTING Tertiary academic referral center. PATIENT A 58-year-old female presented with a small right intracanalicular VS with associated asymmetrical right moderate to severe sensorineural hearing loss, poor word recognition, tinnitus, and disequilibrium. Based on patient symptomatology and goals, simultaneous CI with translabyrinthine resection of the VS was performed. INTERVENTION Cochlear implantation before the tumor was resected facilitated intraoperative eSRs by delivering repeated single-electrode stimulations through the cochlear implant (CI) electrode during tumor resection. A pulse duration of 50-us and a current amplitude of 200-CL or 648-us was used to elicit eSRs visible through the facial recess. Intraoperative eSR was monitored in conjunction with electrically evoked compound action potentials via neural response telemetry and electrical auditory brainstem response. RESULTS Despite the transient evoked compound action potentials amplitude and electrical auditory brainstem response latency changes, the visually observed eSR was preserved and remained robust throughout tumor dissection, indicating an intact cochlear nerve. Four weeks postoperatively, the patient exhibited open-set speech capacity (14% CNC and 36% AzBio in quiet). CONCLUSION The current study demonstrates the feasibility of using intraoperative eSR via a CI electrode to monitor cochlear nerve integrity during VS resection, which may indicate successful CI outcomes. These preliminary findings require further substantiation in a larger study.
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Affiliation(s)
- Armine Kocharyan
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Ghazal S Daher
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Ashley M Nassiri
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Aniket A Saoji
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Matthew L Carlson
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
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Kocharyan A, Daher GS, Nassiri AM, Link MJ, Carlson ML, Driscoll CL. Jugular foramen capillary hemangioma masquerading as a paraganglioma. Am J Otolaryngol 2022; 43:103348. [PMID: 34973661 DOI: 10.1016/j.amjoto.2021.103348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/12/2021] [Indexed: 11/01/2022]
Abstract
Capillary hemangiomas are benign vascular lesions that are common in head and neck, but hemangiomas of jugular foramen and temporal bone are rare with only a few cases reported in the literature. We present a case report of this rare disease entity highlighting the subtle radiographic nuances that can benefit clinicians when encountered with similar unusual clinical scenario. Although radiographic features of capillary hemangioma can be distinctive, they are not specific. In this case, the lack of significant involvement of the jugular bulb and the absence of the typical pattern of osseous erosion of the jugular carotid spine led to the alternative diagnosis of a rare capillary hemangioma of the jugular foramen.
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Daher GS, Choi KY, Wells JW, Goyal N. A Systematic Review of Oral Nutritional Supplement and Wound Healing. Ann Otol Rhinol Laryngol 2022; 131:1358-1368. [PMID: 35043693 DOI: 10.1177/00034894211069437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore the current literature for effects of oral nutritional supplement on wound healing rates in humans. METHODS A systematic review of the literature was performed using the Medline and PubMed database following PRISMA guidelines. The PubMed database was searched using terms relating to oral nutritional supplement and wound healing from 1837 to March 2020. Study inclusion criteria were: (i) design: randomized controlled trials, clinical studies, observational studies, clinical trials; (ii) population: adults; and (iii) intervention: oral nutritional supplement. RESULTS The search yielded 2433 studies, 313 of which were clinical trials or clinical studies. After abstract review, 28 studies qualified to be included in the review evaluating the following supplementation categories on wound healing: protein and amino acids (10), mineral, vitamin and antioxidants (9), probiotics (1), and mixed nutrients (8). Arginine and omega-3 supplement were shown to improve wound healing in head and neck cancer patients with surgical wounds by decreasing incidence of postoperative complications and reducing length of hospital stay. Mineral, vitamins, and antioxidants enriched supplements were more beneficial in increasing wound healing than non-enriched protein supplement for diabetic foot and pressure ulcers. CONCLUSIONS Supplementation of a variety of nutrients had variable effects on improving wound healing in different types of wounds. However, further research on the impact of nutritional supplements on surgical wound healing is necessary. The impact of multiple nutrient formulations may also need to be further evaluated for efficacy.
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Affiliation(s)
- Ghazal S Daher
- The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Karen Y Choi
- Department of Otolaryngology - Head and Neck Surgery, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jeffery W Wells
- Department of Otolaryngology - Head and Neck Surgery, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Neerav Goyal
- Department of Otolaryngology - Head and Neck Surgery, Milton S. Hershey Medical Center, Hershey, PA, USA
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Daher GS, Nassiri AM, Vanichkachorn G, Carlson ML, Neff BA, Driscoll CLW. New onset tinnitus in the absence of hearing changes following COVID-19 infection. Am J Otolaryngol 2022; 43:103208. [PMID: 34536917 PMCID: PMC8429075 DOI: 10.1016/j.amjoto.2021.103208] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/05/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND A variety of neurosensory symptoms including tinnitus have been associated with COVID-19 infection. While most cases of tinnitus are associated with hearing loss, here we report a case of severe tinnitus following COVID-19 infection with normal thresholds through 8000 Hz. CASE REPORT A 49-year-old male presented with new onset severe tinnitus following COVID-19 infection. Tinnitus was bilateral, constant and nonpulsatile. Audiometric evaluation revealed normal threshold through 8000 Hz, with mild hearing loss at 16,000 Hz. Conservative measures including masking strategies failed to mitigate symptoms. A trial of gabapentin 300 mg twice per day improved tinnitus with no notable side effects. CONCLUSION This patient may represent a subpopulation of patients who suffer from severe tinnitus following COVID-19 infection in the setting of largely normal hearing. The pathophysiology may be distinct from the more common hearing loss associated tinnitus and perhaps neuromodulators may play a larger role in mitigating tinnitus in this patient subset.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Ashley M Nassiri
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Greg Vanichkachorn
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Brian A Neff
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Colin L W Driscoll
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America.
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