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Dharmarajan H, Choby G, Abi Hachem R, Kuan EC, Levine CG, Sanusi O, Schuman T, Tang D, Yim M, Geltzeiler M. Treatment of unilateral olfactory neuroblastoma: Appropriate extent of surgical resection and potential for olfactory preservation. Int Forum Allergy Rhinol 2024; 14:881-886. [PMID: 38526915 DOI: 10.1002/alr.23345] [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: 01/15/2024] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
Historically, comprehensive surgical resection for olfactory neuroblastoma has included the bilateral olfactory epithelium, cribriform plate, overlying dura, olfactory bulbs and tracts. This results in postoperative anosmia that may significantly impact a patient's quality of life without definitive added benefit in survival. The prevalence of occult intracranial disease is low, especially for Hyams grade I and II tumors. A unilateral approach sparing the contralateral cribriform plate and olfactory system can be considered for select cases of early stage, low-grade tumors when the disease does not cross midline to involve the contralateral olfactory cleft or septal mucosa and when midline dural margins can be cleared with frozen pathology. Approximately half of patients who undergo unilateral resection may have residual olfaction even with adjuvant unilateral radiation. Early data suggest favorable disease-free survival and overall survival for patients who underwent the unilateral approach; however, larger sample studies are needed to confirm comparability to bilateral resections regarding oncologic outcomes.
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Affiliation(s)
- Harish Dharmarajan
- Department of Otolaryngology, Oregon Health and Science University, Portland, Oregon, USA
| | - Garret Choby
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Edward C Kuan
- Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
| | - Corinna G Levine
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Olabisi Sanusi
- Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Theodore Schuman
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dennis Tang
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai, Los Angeles, California, USA
| | - Michael Yim
- Department of Otolaryngology-Head and Neck Surgery, LSU Health, Shreveport, Louisiana, USA
| | - Mathew Geltzeiler
- Department of Otolaryngology, Oregon Health and Science University, Portland, Oregon, USA
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Pingree G, DeShazo J, Schuman T. Impact of dual electronic and conventional cigarette use on diagnosis and surgery for chronic rhinosinusitis: A multicenter study. Int Forum Allergy Rhinol 2024; 14:977-980. [PMID: 37788170 DOI: 10.1002/alr.23281] [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: 04/26/2023] [Revised: 08/25/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
KEY POINTS Dual EC/CC users had a significantly greater risk of CRS or FESS when compared to solo users. Dual EC/CC users did not have a significantly greater risk of polyposis when compared to solo users. This effect likely relates to bacterial, immune cell, genetic, and mucociliary alterations.
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Affiliation(s)
- Graham Pingree
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jonathan DeShazo
- Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Theodore Schuman
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
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Vahidi N, Kwak P, Sismanis D, Schuman T, Hawkins D, Lee TS. Management of Complications and Secondary Deformity After Fractures of the Midface, Orbit, and Upper Third of the Maxillofacial Skeleton. Otolaryngol Clin North Am 2023; 56:1151-1167. [PMID: 37442663 DOI: 10.1016/j.otc.2023.05.011] [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] [Indexed: 07/15/2023]
Abstract
Craniomaxillofacial trauma is a challenging entity to manage effectively and often necessitates serial evaluation and treatment. A multidisciplinary team is best served to evaluate and treat these complex injury patterns with the use of necessary adjuncts, such as neuronavigation, intraoperative imaging, custom implant use, and virtual surgical planning. Complications of facial trauma can present at a spectrum of time points and manifest in a variety of manners and as such patients should be observed closely and longitudinally. Although not all complications and secondary deformities can be avoided, this article highlights some common pitfalls and our unique management strategies.
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Affiliation(s)
- Nima Vahidi
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University, 1200 East Broad Street, West Hospital, 12th Floor, South Wing, Suite 313, Clinic Box 980146, Academic Box 980237, Richmond, VA 23298-0146, USA
| | - Peter Kwak
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University, 1200 East Broad Street, West Hospital, 12th Floor, South Wing, Suite 313, Clinic Box 980146, Academic Box 980237, Richmond, VA 23298-0146, USA
| | - Dimitrios Sismanis
- Oculoplastic Surgery, Virginia Oculofacial Surgeons, 1630 WIlkes Ridges Parkway Suite 102, Richmond, VA 23233, USA
| | - Theodore Schuman
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University, 1200 East Broad Street, West Hospital, 12th Floor, South Wing, Suite 313, Clinic Box 980146, Academic Box 980237, Richmond, VA 23298-0146, USA
| | - Daniel Hawkins
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, School of Dentistry, Dental Building 1, 521 North 11th Street, Richmond, VA 23298-0566, USA
| | - Thomas S Lee
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University, 1200 East Broad Street, West Hospital, 12th Floor, South Wing, Suite 313, Clinic Box 980146, Academic Box 980237, Richmond, VA 23298-0146, USA.
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Abstract
Objectives YouTube is the second most visited website in the world and can be a useful resource for patients to gain insight into surgical procedures. A multitude of studies have evaluated the quality of otolaryngology-specific healthcare information available on the YouTube platform, but to our knowledge, the online content regarding functional endoscopic sinus surgery available on this site has not been systematically evaluated. Study Design Cross sectional study. Setting Online. Methods YouTube was searched using the keywords “sinus surgery.” Variables including video length, total number of views, authorship (academic, private practice physician, patient, or third party), objective (advertisement, informative, or patient perspective), inclusion of intra-operative footage, and discussion of balloon sinuplasty were recorded and analyzed by a single reviewer. Results Two-hundred twenty-two videos met inclusion criteria, with a median length of 4 minutes, and a median of 3349 views. The majority of videos were informative (n = 145, 65%), narrated (n = 151, 68%), and did not mention balloon sinuplasty (n = 189, 85%) nor contain intra-operative footage (n = 116, 52%). Private practice physicians were the most common authors (n = 113, 51%), followed by patients (n = 70, 32%), third parties (n = 28, 13%) and academics (n = 11, 5%). Conclusions Sinus surgery is one of the most common ambulatory procedures performed. Online resources such as YouTube can be useful for improving health literacy and patient comfort with medical topics such as functional endoscopic sinus surgery, but it is important for clinicians and patients to understand that there is a spectrum in the authorship, content, and quality of sinus surgery related videos posted online.
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Affiliation(s)
- Arthur Uyesugi
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Shannon Moldowan
- Department of Biostatistics - Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Keighly Bradbrook
- Department of Biostatistics - Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Theodore Schuman
- Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
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Manniello MD, Hosseini S, Alfaifi A, Esmaeili AR, Kolanjiyil AV, Walenga R, Babiskin A, Sandell D, Mohammadi R, Schuman T, Hindle M, Golshahi L. In vitro evaluation of regional nasal drug delivery using multiple anatomical nasal replicas of adult human subjects and two nasal sprays. Int J Pharm 2020; 593:120103. [PMID: 33242586 DOI: 10.1016/j.ijpharm.2020.120103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/21/2020] [Revised: 11/10/2020] [Accepted: 11/15/2020] [Indexed: 01/25/2023]
Abstract
Quantifying drug delivery to the site of action using locally-acting nasal suspension sprays is a challenging but important step toward understanding bioequivalence (BE) between test and reference products. The main objective of this study was to investigate the in vitro deposition pattern of two common but different locally-acting nasal suspension sprays using multiple nasal cavities. Twenty anatomically accurate nasal replicas were developed from high-resolution sinonasal computed tomography scans of adults with healthy nasal airways. The airways were segmented into two regions of anterior and posterior to the internal nasal valve. Both sides of the septum were considered separately; hence, 40 nasal cavities were studied. The positioning of the spray nozzle in all 40 cavities was characterized by the head angle, coronal angle, and the insertion depth. Despite using a controlled protocol to minimize the anterior losses, a wide range of variability in posterior drug delivery was observed. The observed intersubject variability using this in vitro method may have important implications for understanding BE of locally-acting nasal suspension sprays.
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Affiliation(s)
- Michele Dario Manniello
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Sana Hosseini
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Ali Alfaifi
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA; Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | - Amir R Esmaeili
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Arun V Kolanjiyil
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Ross Walenga
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrew Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | - Reza Mohammadi
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Theodore Schuman
- Department of Otolaryngology- Head and Neck Surgery, VCU Health, Richmond, VA, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | - Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA.
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Adams K, Klatt-Cromwell C, Schuman T, Thorp B, Ebert C, Sasaki-Adams D, Ewend M, Zanation A. Comparative Anatomic Skull Base Approaches to the Nasopharynx and Pharyngeal Aerodigestive Tract. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600720] [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: 10/20/2022]
Affiliation(s)
| | | | | | - Brian Thorp
- UNC Chapel Hill, Chapel Hill, North Carolina, United States
| | - Charles Ebert
- UNC Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Matthew Ewend
- UNC Chapel Hill, Chapel Hill, North Carolina, United States
| | - Adam Zanation
- UNC Chapel Hill, Chapel Hill, North Carolina, United States
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Schuman T, Adams K, Klatt-Kromwell C, Thorp B, Ebert C, Sasaki-Adams D, Ewend M, Zanation A. Endoscopic Windows for Increased Visualization in Endoscopic Skull Base Surgery. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600748] [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: 10/20/2022]
Affiliation(s)
- Theodore Schuman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Katherine Adams
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Brian Thorp
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Charles Ebert
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Deanna Sasaki-Adams
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Matthew Ewend
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Adam Zanation
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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Klatt-Cromwell C, Adams K, Schuman T, Thorp B, Ebert C, Sasaki-Adams D, Ewend M, Zanation A. Internal Carotid Artery Exposure: An Anatomic Study of Endoscopic and Open Anterior Transfacial Approaches. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600526] [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: 10/20/2022]
Affiliation(s)
| | - Katherine Adams
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Theodore Schuman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Brian Thorp
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Charles Ebert
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Deanna Sasaki-Adams
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Matthew Ewend
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Adam Zanation
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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Abstract
Oncolytic herpes simplex viruses (HSV) have demonstrated potent antitumoral effects against a variety of human malignancies in preclinical studies and are in early clinical trials. We explored the activity of an attenuated, replication-competent, oncolytic HSV (NV1023) for the treatment of human salivary gland carcinomas. NV1023 was able to successfully enter into 4 mucoepidermoid carcinoma (H292, H3118, HTB-41, UT-MUC-1) and 2 adenocarcinoma (HSY, HSG) cell lines, as measured by lacZ assays after exposure to 5 viral particles per cell (MOI 5). Viral plaque assays showed variation of viral replication within these cell lines, ranging from a 268-fold increase (H292) to a 3-fold increase (HSG) in viral titer. At MOI 5, all cell lines showed >95% cytotoxicity from NV1023 by Day 7, except for HSY (73%). At MOI 0.1, H3118 and UT-MUC-1 remained highly sensitive to NV1023, both showing >95% cytotoxicity by Day 7. The mucoepidermoid carcinomas were more sensitive to NV1023 at low viral concentrations compared with the adenocarcinomas. Flank tumors of H3118, HTB-41 and HSY in nude mice showed significant tumor volume reductions after a single intratumoral injection of NV1023 (2 x 10(7) plaque-forming units). These data suggest that oncolytic herpes viruses have significant efficacy entering, replicating within, and lysing human salivary gland carcinomas. These promising biologic agents should be further investigated as novel therapy for patients with salivary carcinomas failing conventional treatment.
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Affiliation(s)
- Vincent Reid
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Nazarenko S, Dennison M, Schuman T, Stepanov EV, Hiltner A, Baer E. Creating layers of concentrated inorganic particles by interdiffusion of polyethylenes in microlayers. J Appl Polym Sci 1999. [DOI: 10.1002/(sici)1097-4628(19990929)73:14<2877::aid-app11>3.0.co;2-o] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schuman T, Stepanov EV, Nazarenko S, Capaccio G, Hiltner A, Baer E. Interdiffusion of Linear and Branched Polyethylene in Microlayers Studied via Melting Behavior. Macromolecules 1998. [DOI: 10.1021/ma971758e] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T. Schuman
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
| | - E. V. Stepanov
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
| | - S. Nazarenko
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
| | - G. Capaccio
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
| | - A. Hiltner
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
| | - E. Baer
- Department of Macromolecular Science and Center for Applied Polymer Research, Case Western Reserve University, Cleveland, Ohio 44106, and BP Chemicals, Ltd., Applied Technology, Grangemouth, FK3 9XH, U.K
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Schuman T. Nurses reach out to Internet. Oreg Nurse 1996; 61:4. [PMID: 9006211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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