Merry Sebelik | Emory University (original) (raw)

Papers by Merry Sebelik

Research paper thumbnail of A Systematic Review of Simulation in Otolaryngology Residency Training

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does th... more ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does the field of otolaryngology stand in incorporating simulation into residency training? We believe there has been a profound increase in the use of simulation in otolaryngology residency training programs recently, which can be described by a simultaneous increase in the number of otolaryngology simulation-based publications. Study Design: Systematic review. Data Sources: A literature search was performed using the Ovid Medline and PubMed search engines.

Research paper thumbnail of Chondroradionecrosis of the larynx in patients treated with organ preservation therapy

Otolaryngology - Head and Neck Surgery, 2004

ABSTRACT Objectives: In recent years, there is increasing emphasis on organ-sparing treatment par... more ABSTRACT Objectives: In recent years, there is increasing emphasis on organ-sparing treatment paradigms for advanced head and neck cancer patients for whom the surgical treatment option would otherwise include total laryngectomy. However, there may be increased complications of therapy such as loss of voice, airway, and aspiration control due to chondroradionecrosis. The purpose of this study is to determine the incidence of chondroradionecrosis in a population of patients treated with organ-sparing intent and to analyze the risk factors and management issues.Methods: A total of 129 patients with Stage III and IV squamous cell carcinoma of the larynx or hypopharynx were treated with concurrent radiotherapy and targeted with intra-arterial infusion of cisplatin for definitive curative treatment and larynx preservation over a 9-year period. The research database pertaining to these patients and their hospital and outpatient charts was reviewed.Results: Twelve of 129 patients (9.3%) developed Chandler Grade III or IV chondroradionecrosis of the larynx in the posttreatment period; 3/12 (25%) required total laryngectomy for resolution of the necrosis and 1/12 (8.3%) underwent a surgical procedure for aspiration control. This represents an overall need for nonmalignant laryngectomy in this treatment population of 2.3%.Conclusions: The percentage of chemoradiotherapy patients with chondroradionecrosis appears increased as compared to previous patients treated with radiotherapy alone. However, the risk (2.3%) of total laryngectomy for chondroradionecrosis may be acceptable to many or most individuals with advanced head and neck cancer. It is imperative that this issue be discussed in advance to allow patients to make informed treatment decisions.

Research paper thumbnail of SP204 – Operative vs nonoperative staging for head and neck cancer

Otolaryngology - Head and Neck Surgery, 2009

Research paper thumbnail of Oral Cavity Manifestations of Visceral Leishmaniasis

Otolaryngology - Head and Neck Surgery, 2010

Research paper thumbnail of A Systematic Review of Simulation in Otolaryngology Residency Training

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does th... more ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does the field of otolaryngology stand in incorporating simulation into residency training? We believe there has been a profound increase in the use of simulation in otolaryngology residency training programs recently, which can be described by a simultaneous increase in the number of otolaryngology simulation-based publications. Study Design: Systematic review. Data Sources: A literature search was performed using the Ovid Medline and PubMed search engines.

Research paper thumbnail of Contemporary Ultrasound of the Head and Neck

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Program Description: With the progressive improvements in imaging resolution of ultrasou... more ABSTRACT Program Description: With the progressive improvements in imaging resolution of ultrasound, concurrent reduction in capital expenditure, and portability, this modality is ideally suited to point-of-care use by most otolaryngology practices. Primary and exported training courses through the American College of Surgeons have provided a clinical starting point. An accreditation process for head and neck ultrasound is now available through a joint project between the American Institute for Ultrasound in Medicine and the Academy. This miniseminar presents the practical application of ultrasound to general, pediatric, endocrinologic, and oncologic conditions through a panel of outstanding experts from radiology and otolaryngology.

Research paper thumbnail of Sources and Quality of Online Surgical Videos: Using YouTube to Learn Thyroid Surgery

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Estimate the volume of thyroid surgery-related video content readily ava... more ABSTRACT Objectives: (1) Estimate the volume of thyroid surgery-related video content readily available to the surgical trainee. (2) Stratify the sources of thyroid surgery-related video content by source (patient, institution, surgeon, or other) and estimate the quality of the surgeon source by related scholarly output.

Research paper thumbnail of Novel Techniques in Head and Neck Ultrasound

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Report new uses of ultrasound within the head and neck. 2) Emphasize how t... more ABSTRACT Objective: 1) Report new uses of ultrasound within the head and neck. 2) Emphasize how the use of ultrasound can enhance patient management and alter treatment delivery. Method: Present a series of 7 cases from the past year at a single academic institution where ultrasound was used in a novel way to enhance patient care. Compare the ultrasound images obtained with other imaging modalities. Results: Three patients underwent ultrasound-guided fine- needle aspiration (FNA) of tongue base tumors, which avoided the necessity of a tracheotomy in 1 patient with a difficult airway. Two patients underwent ultrasound-guided FNA of supraglottic tumors through the thyrohyoid membrane, which obviated the need for biopsy with general anesthesia. One noncancer patient had a highly metabolic enlarged lymph node on PET/CT though it demonstrated benign characteristics on ultrasound. Both ultrasound-guided FNA and incisional biopsy confirmed the lymph node's benignity. One patient had a vallecular foreign body seen on ultrasound but not on flexible laryngoscopy, and it was retrieved in the operating room. Conclusion: Ultrasound can be used to guide FNA for tissue diagnosis from tongue base and larynx tumors. Ultrasound-guided FNA may eliminate the need for biopsy under general anesthesia for some patients. Ultrasound has an expanding array of applications and is a useful tool in the otolaryngologist's hands. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Surgical Skills of Applicants to Residency in Otolaryngology

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Measure baseline competence in the performance of a basic surgical task by... more ABSTRACT Objective: 1) Measure baseline competence in the performance of a basic surgical task by 4th-year medical students applying to otolaryngology residency. 2) Determine whether information available in the standardized otolaryngology residency application correlates with competence in performance of the basic surgical task. Method: Applicants to residency in otolaryngology with the University of Tennessee Health Science Center in 2010 and 2011 constituted the study population. During the interview, the applicant was asked to close a simulated incision with sutures. A blinded observer recorded a 15-point Objective Surgical Assessment of Technical Skill score. Results: The OSATS score provided a measure of the suturing skills of individuals applying to residency training in otolaryngology. The OSATS score was incorporated into the calculation of an overall OSCE (Objective Structured Clinical Examination) score modified to focus on surgical skill performance and a professionalism measure. Initial data analysis produced a correlation value (R value) between the OSCE score and data points gleaned from the standardized application (USMLE step I score, prior employment-related surgical experience, hobbies, musical background, athletic background, research experience that includes performance of surgical procedures). Conclusion: In contrast to other high-skill professions such as the airline industry, surgical educators have not universally developed a practice of testing prospective trainees for aptitudes that can be deemed critical to surgical competence. This study represents a methodology for assessment of a simple surgical skill to which all applicants to otolaryngology training should have been exposed. It also determines correlation with applicant data commonly used in selection, such as USMLE score. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Otolaryngology Simulation Forum: A Potpourri from the Cutting Edge

Otolaryngology -- Head and Neck Surgery, 2012

Research paper thumbnail of Ultrasound Training in Otolaryngology Residencies

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Estimate the current state of ultrasound experience among United States ot... more ABSTRACT Objective: 1) Estimate the current state of ultrasound experience among United States otolaryngology residents. 2) Describe self-reported proficiency levels among senior residents in specific head and neck ultrasound techniques. 3) Identify deficiencies in ultrasound education and determine barriers to residents' future use of ultrasound. Method: Midway through the academic year (January 2012), a link with an electronic survey was sent via email to every residency program director in the United States with a request to distribute the survey to the residents (PGY 1-5). Survey responses were recorded anonymously and analyzed. Results: A total of 123 residents responded. Of these, 62 (50.4%) had informal ultrasound training during residency, and 11 (9%) had attended a formal ultrasound course. Senior residents (PGY 4-5, n = 52) had personally performed thyroid imaging (46.2%), thyroid FNA (32.7%), parathyroid imaging (19.2%), lymph node assessment (23.1%), salivary gland stone assessment (9.8%), and vocal cord mobility assessment (5.9%). Barriers to future ultrasound use included an inability to perform ultrasound (49.2%), cost of ultrasound machine (34.2%), and concerns about credentialing (32.5%). When asked if their exposure to ultrasound in residency was adequate, 27 (22.3%) said "yes," 63 (52.1%) said "no," and 31 (25.6%) said "unsure." Conclusion: United States otolaryngology residents have had variable exposure to ultrasound training. Less than half of senior residents have performed basic ultrasound skills. The biggest perceived impediment to future ultrasound use among prospective otolaryngologists is an inability to perform ultrasound, and relatively few otolaryngology residents feel their ultrasound training is adequate. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Ultrasound-Guided FNA of Base of Tongue: A Cadaver Study

Otolaryngology -- Head and Neck Surgery, 2011

ABSTRACT Objective: 1) Determine the utility of ultrasound imaging to visualize the anatomy of th... more ABSTRACT Objective: 1) Determine the utility of ultrasound imaging to visualize the anatomy of the tongue base. 2) Demonstrate that ultrasound imaging can guide transcervical needle placement in the tongue base and thus serve as a surrogate for needle biopsy in the patient with a tongue base lesion.

Research paper thumbnail of Intraoperative Detection of Parathyroid Glands: A Systematic Review and Novel Low-Tech Alternative

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Perform systematic review of the literature discussing methods of intrao... more ABSTRACT Objectives: (1) Perform systematic review of the literature discussing methods of intraoperative detection of parathyroid glands. (2) Determine the feasibility of a low-cost visual identification method using cell phone camera and photographic color analysis.

Research paper thumbnail of Effects of sensory or motor nerve deafferentation on oromotor function in mice

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2011

To investigate the effect of sensory or motor nerve damage to the tongue using a mouse model. Ani... more To investigate the effect of sensory or motor nerve damage to the tongue using a mouse model. Animal study. Research laboratory. Adult male and female mice from inbred strains B6 (n = 19) and D2 (n = 25). Following lick training, bilateral lingual-chorda tympani nerve cuts (LX) (n = 6 B6, n = 7 D2), unilateral hypoglossal nerve cuts (HX) (n = 7 B6, n = 9 D2), or sham surgery (n = 6 B6, n = 9 D2) was performed. Mice were lick tested postsurgically with both water and sucrose (4 days total). Following testing, post mortem dissections and microscopic analysis of tongue papillae were performed. In both strains, HX and LX mice demonstrated a significant reduction in volume per lick (VPL) in the surgical groups relative to shams. Neither motor nor sensory nerve transection affected local lick rate. In most LX mice in both strains, taste papillae were reduced compared with HX or sham mice. Mice of either strain with either a sensory or a motor nerve injury have a significant loss of VPL du...

Research paper thumbnail of Cutaneous angiosarcoma of the head and neck: a case presentation and review of the literature

Ear, nose, & throat journal, 2006

Cutaneous angiosarcoma of the head and neck is a rare vascular neoplasm. When it does occur, it i... more Cutaneous angiosarcoma of the head and neck is a rare vascular neoplasm. When it does occur, it is most common in elderly white men. Early diagnosis and treatment are essential for local control of this aggressive tumor but recognition can be delayed because of its rarity or because of difficulty in making a pathologic diagnosis. A combined-modality treatment approach is most often advocated. We report the case of a 77-year-old black man who presented with a 1-month history of two painless, violaceous, subcentimeter nodules of the upper lip. After a diagnosis of low-grade angiosarcoma was definitively established, the lesions were locally excised with good cosmetic and functional results. The patient subsequently was found to have probable metastatic disease, but he declined further intervention. We review the literature on cutaneous angiosarcoma, and we discuss its epidemiology, presentation, tissue diagnosis, treatment, and prognosis in an effort to increase awareness of this rare...

Research paper thumbnail of Postoperative wound infection in head and neck oncologic procedures

Acta oto-rhino-laryngologica Belgica, 1999

Research paper thumbnail of Actinomycosis presenting as a temporal mass

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2005

Research paper thumbnail of Factors predictive of poor functional outcome after chemoradiation for advanced laryngeal cancer

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2002

The study goal was to determine whether pretreatment parameters can be used to predict poor outco... more The study goal was to determine whether pretreatment parameters can be used to predict poor outcomes related to laryngeal function among survivors after organ preservation therapy for advanced laryngeal cancer. A retrospective analysis of patients treated in an ongoing chemoradiation trial. Academic tertiary care referral medical center. PATIENDS AND METHODS: Among the 65 patients receiving concomitant intra-arterial cisplatin and radiation therapy for stage III and IV laryngeal cancer between 1993 and 1999, we identified 45 who were available for follow-up and were disease free 6 months after the completion of therapy. A nominal logistic regression analysis was performed to study the effect of age, gender, T and N classification, vocal cord fixation, massive cartilage destruction, and neck dissection on the likelihood of requiring a tracheostomy tube for breathing and/or a gastrostomy tube for feeding at 6 months after the completion of therapy. Persistent use of gastrostomy tube f...

Research paper thumbnail of Anterior Skull Reconstruction: Does Fat Preparation Matter?

Journal of Neurological Surgery Part B: Skull Base, 2015

Research paper thumbnail of Management of Primary Hyperparathyroidism in a VAMC Health System: Evidence-Based Management Protocol and Future Directions

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Establish a best practices guideline for the surgical treatment of prima... more ABSTRACT Objectives: (1) Establish a best practices guideline for the surgical treatment of primary hyperparathyroidism within the context of single hospital system. (2) Stratify the group of patients who underwent directed excision by the accuracy of preoperative localization studies, and whether intraoperative techniques impacted cure, and at what resource costs.

Research paper thumbnail of A Systematic Review of Simulation in Otolaryngology Residency Training

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does th... more ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does the field of otolaryngology stand in incorporating simulation into residency training? We believe there has been a profound increase in the use of simulation in otolaryngology residency training programs recently, which can be described by a simultaneous increase in the number of otolaryngology simulation-based publications. Study Design: Systematic review. Data Sources: A literature search was performed using the Ovid Medline and PubMed search engines.

Research paper thumbnail of Chondroradionecrosis of the larynx in patients treated with organ preservation therapy

Otolaryngology - Head and Neck Surgery, 2004

ABSTRACT Objectives: In recent years, there is increasing emphasis on organ-sparing treatment par... more ABSTRACT Objectives: In recent years, there is increasing emphasis on organ-sparing treatment paradigms for advanced head and neck cancer patients for whom the surgical treatment option would otherwise include total laryngectomy. However, there may be increased complications of therapy such as loss of voice, airway, and aspiration control due to chondroradionecrosis. The purpose of this study is to determine the incidence of chondroradionecrosis in a population of patients treated with organ-sparing intent and to analyze the risk factors and management issues.Methods: A total of 129 patients with Stage III and IV squamous cell carcinoma of the larynx or hypopharynx were treated with concurrent radiotherapy and targeted with intra-arterial infusion of cisplatin for definitive curative treatment and larynx preservation over a 9-year period. The research database pertaining to these patients and their hospital and outpatient charts was reviewed.Results: Twelve of 129 patients (9.3%) developed Chandler Grade III or IV chondroradionecrosis of the larynx in the posttreatment period; 3/12 (25%) required total laryngectomy for resolution of the necrosis and 1/12 (8.3%) underwent a surgical procedure for aspiration control. This represents an overall need for nonmalignant laryngectomy in this treatment population of 2.3%.Conclusions: The percentage of chemoradiotherapy patients with chondroradionecrosis appears increased as compared to previous patients treated with radiotherapy alone. However, the risk (2.3%) of total laryngectomy for chondroradionecrosis may be acceptable to many or most individuals with advanced head and neck cancer. It is imperative that this issue be discussed in advance to allow patients to make informed treatment decisions.

Research paper thumbnail of SP204 – Operative vs nonoperative staging for head and neck cancer

Otolaryngology - Head and Neck Surgery, 2009

Research paper thumbnail of Oral Cavity Manifestations of Visceral Leishmaniasis

Otolaryngology - Head and Neck Surgery, 2010

Research paper thumbnail of A Systematic Review of Simulation in Otolaryngology Residency Training

Otolaryngology -- Head and Neck Surgery, 2013

ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does th... more ABSTRACT Objectives: The central premise of our systematic review was to determine: Where does the field of otolaryngology stand in incorporating simulation into residency training? We believe there has been a profound increase in the use of simulation in otolaryngology residency training programs recently, which can be described by a simultaneous increase in the number of otolaryngology simulation-based publications. Study Design: Systematic review. Data Sources: A literature search was performed using the Ovid Medline and PubMed search engines.

Research paper thumbnail of Contemporary Ultrasound of the Head and Neck

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Program Description: With the progressive improvements in imaging resolution of ultrasou... more ABSTRACT Program Description: With the progressive improvements in imaging resolution of ultrasound, concurrent reduction in capital expenditure, and portability, this modality is ideally suited to point-of-care use by most otolaryngology practices. Primary and exported training courses through the American College of Surgeons have provided a clinical starting point. An accreditation process for head and neck ultrasound is now available through a joint project between the American Institute for Ultrasound in Medicine and the Academy. This miniseminar presents the practical application of ultrasound to general, pediatric, endocrinologic, and oncologic conditions through a panel of outstanding experts from radiology and otolaryngology.

Research paper thumbnail of Sources and Quality of Online Surgical Videos: Using YouTube to Learn Thyroid Surgery

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Estimate the volume of thyroid surgery-related video content readily ava... more ABSTRACT Objectives: (1) Estimate the volume of thyroid surgery-related video content readily available to the surgical trainee. (2) Stratify the sources of thyroid surgery-related video content by source (patient, institution, surgeon, or other) and estimate the quality of the surgeon source by related scholarly output.

Research paper thumbnail of Novel Techniques in Head and Neck Ultrasound

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Report new uses of ultrasound within the head and neck. 2) Emphasize how t... more ABSTRACT Objective: 1) Report new uses of ultrasound within the head and neck. 2) Emphasize how the use of ultrasound can enhance patient management and alter treatment delivery. Method: Present a series of 7 cases from the past year at a single academic institution where ultrasound was used in a novel way to enhance patient care. Compare the ultrasound images obtained with other imaging modalities. Results: Three patients underwent ultrasound-guided fine- needle aspiration (FNA) of tongue base tumors, which avoided the necessity of a tracheotomy in 1 patient with a difficult airway. Two patients underwent ultrasound-guided FNA of supraglottic tumors through the thyrohyoid membrane, which obviated the need for biopsy with general anesthesia. One noncancer patient had a highly metabolic enlarged lymph node on PET/CT though it demonstrated benign characteristics on ultrasound. Both ultrasound-guided FNA and incisional biopsy confirmed the lymph node's benignity. One patient had a vallecular foreign body seen on ultrasound but not on flexible laryngoscopy, and it was retrieved in the operating room. Conclusion: Ultrasound can be used to guide FNA for tissue diagnosis from tongue base and larynx tumors. Ultrasound-guided FNA may eliminate the need for biopsy under general anesthesia for some patients. Ultrasound has an expanding array of applications and is a useful tool in the otolaryngologist's hands. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Surgical Skills of Applicants to Residency in Otolaryngology

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Measure baseline competence in the performance of a basic surgical task by... more ABSTRACT Objective: 1) Measure baseline competence in the performance of a basic surgical task by 4th-year medical students applying to otolaryngology residency. 2) Determine whether information available in the standardized otolaryngology residency application correlates with competence in performance of the basic surgical task. Method: Applicants to residency in otolaryngology with the University of Tennessee Health Science Center in 2010 and 2011 constituted the study population. During the interview, the applicant was asked to close a simulated incision with sutures. A blinded observer recorded a 15-point Objective Surgical Assessment of Technical Skill score. Results: The OSATS score provided a measure of the suturing skills of individuals applying to residency training in otolaryngology. The OSATS score was incorporated into the calculation of an overall OSCE (Objective Structured Clinical Examination) score modified to focus on surgical skill performance and a professionalism measure. Initial data analysis produced a correlation value (R value) between the OSCE score and data points gleaned from the standardized application (USMLE step I score, prior employment-related surgical experience, hobbies, musical background, athletic background, research experience that includes performance of surgical procedures). Conclusion: In contrast to other high-skill professions such as the airline industry, surgical educators have not universally developed a practice of testing prospective trainees for aptitudes that can be deemed critical to surgical competence. This study represents a methodology for assessment of a simple surgical skill to which all applicants to otolaryngology training should have been exposed. It also determines correlation with applicant data commonly used in selection, such as USMLE score. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Otolaryngology Simulation Forum: A Potpourri from the Cutting Edge

Otolaryngology -- Head and Neck Surgery, 2012

Research paper thumbnail of Ultrasound Training in Otolaryngology Residencies

Otolaryngology -- Head and Neck Surgery, 2012

ABSTRACT Objective: 1) Estimate the current state of ultrasound experience among United States ot... more ABSTRACT Objective: 1) Estimate the current state of ultrasound experience among United States otolaryngology residents. 2) Describe self-reported proficiency levels among senior residents in specific head and neck ultrasound techniques. 3) Identify deficiencies in ultrasound education and determine barriers to residents' future use of ultrasound. Method: Midway through the academic year (January 2012), a link with an electronic survey was sent via email to every residency program director in the United States with a request to distribute the survey to the residents (PGY 1-5). Survey responses were recorded anonymously and analyzed. Results: A total of 123 residents responded. Of these, 62 (50.4%) had informal ultrasound training during residency, and 11 (9%) had attended a formal ultrasound course. Senior residents (PGY 4-5, n = 52) had personally performed thyroid imaging (46.2%), thyroid FNA (32.7%), parathyroid imaging (19.2%), lymph node assessment (23.1%), salivary gland stone assessment (9.8%), and vocal cord mobility assessment (5.9%). Barriers to future ultrasound use included an inability to perform ultrasound (49.2%), cost of ultrasound machine (34.2%), and concerns about credentialing (32.5%). When asked if their exposure to ultrasound in residency was adequate, 27 (22.3%) said "yes," 63 (52.1%) said "no," and 31 (25.6%) said "unsure." Conclusion: United States otolaryngology residents have had variable exposure to ultrasound training. Less than half of senior residents have performed basic ultrasound skills. The biggest perceived impediment to future ultrasound use among prospective otolaryngologists is an inability to perform ultrasound, and relatively few otolaryngology residents feel their ultrasound training is adequate. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.

Research paper thumbnail of Ultrasound-Guided FNA of Base of Tongue: A Cadaver Study

Otolaryngology -- Head and Neck Surgery, 2011

ABSTRACT Objective: 1) Determine the utility of ultrasound imaging to visualize the anatomy of th... more ABSTRACT Objective: 1) Determine the utility of ultrasound imaging to visualize the anatomy of the tongue base. 2) Demonstrate that ultrasound imaging can guide transcervical needle placement in the tongue base and thus serve as a surrogate for needle biopsy in the patient with a tongue base lesion.

Research paper thumbnail of Intraoperative Detection of Parathyroid Glands: A Systematic Review and Novel Low-Tech Alternative

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Perform systematic review of the literature discussing methods of intrao... more ABSTRACT Objectives: (1) Perform systematic review of the literature discussing methods of intraoperative detection of parathyroid glands. (2) Determine the feasibility of a low-cost visual identification method using cell phone camera and photographic color analysis.

Research paper thumbnail of Effects of sensory or motor nerve deafferentation on oromotor function in mice

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2011

To investigate the effect of sensory or motor nerve damage to the tongue using a mouse model. Ani... more To investigate the effect of sensory or motor nerve damage to the tongue using a mouse model. Animal study. Research laboratory. Adult male and female mice from inbred strains B6 (n = 19) and D2 (n = 25). Following lick training, bilateral lingual-chorda tympani nerve cuts (LX) (n = 6 B6, n = 7 D2), unilateral hypoglossal nerve cuts (HX) (n = 7 B6, n = 9 D2), or sham surgery (n = 6 B6, n = 9 D2) was performed. Mice were lick tested postsurgically with both water and sucrose (4 days total). Following testing, post mortem dissections and microscopic analysis of tongue papillae were performed. In both strains, HX and LX mice demonstrated a significant reduction in volume per lick (VPL) in the surgical groups relative to shams. Neither motor nor sensory nerve transection affected local lick rate. In most LX mice in both strains, taste papillae were reduced compared with HX or sham mice. Mice of either strain with either a sensory or a motor nerve injury have a significant loss of VPL du...

Research paper thumbnail of Cutaneous angiosarcoma of the head and neck: a case presentation and review of the literature

Ear, nose, & throat journal, 2006

Cutaneous angiosarcoma of the head and neck is a rare vascular neoplasm. When it does occur, it i... more Cutaneous angiosarcoma of the head and neck is a rare vascular neoplasm. When it does occur, it is most common in elderly white men. Early diagnosis and treatment are essential for local control of this aggressive tumor but recognition can be delayed because of its rarity or because of difficulty in making a pathologic diagnosis. A combined-modality treatment approach is most often advocated. We report the case of a 77-year-old black man who presented with a 1-month history of two painless, violaceous, subcentimeter nodules of the upper lip. After a diagnosis of low-grade angiosarcoma was definitively established, the lesions were locally excised with good cosmetic and functional results. The patient subsequently was found to have probable metastatic disease, but he declined further intervention. We review the literature on cutaneous angiosarcoma, and we discuss its epidemiology, presentation, tissue diagnosis, treatment, and prognosis in an effort to increase awareness of this rare...

Research paper thumbnail of Postoperative wound infection in head and neck oncologic procedures

Acta oto-rhino-laryngologica Belgica, 1999

Research paper thumbnail of Actinomycosis presenting as a temporal mass

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2005

Research paper thumbnail of Factors predictive of poor functional outcome after chemoradiation for advanced laryngeal cancer

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2002

The study goal was to determine whether pretreatment parameters can be used to predict poor outco... more The study goal was to determine whether pretreatment parameters can be used to predict poor outcomes related to laryngeal function among survivors after organ preservation therapy for advanced laryngeal cancer. A retrospective analysis of patients treated in an ongoing chemoradiation trial. Academic tertiary care referral medical center. PATIENDS AND METHODS: Among the 65 patients receiving concomitant intra-arterial cisplatin and radiation therapy for stage III and IV laryngeal cancer between 1993 and 1999, we identified 45 who were available for follow-up and were disease free 6 months after the completion of therapy. A nominal logistic regression analysis was performed to study the effect of age, gender, T and N classification, vocal cord fixation, massive cartilage destruction, and neck dissection on the likelihood of requiring a tracheostomy tube for breathing and/or a gastrostomy tube for feeding at 6 months after the completion of therapy. Persistent use of gastrostomy tube f...

Research paper thumbnail of Anterior Skull Reconstruction: Does Fat Preparation Matter?

Journal of Neurological Surgery Part B: Skull Base, 2015

Research paper thumbnail of Management of Primary Hyperparathyroidism in a VAMC Health System: Evidence-Based Management Protocol and Future Directions

Otolaryngology -- Head and Neck Surgery, 2014

ABSTRACT Objectives: (1) Establish a best practices guideline for the surgical treatment of prima... more ABSTRACT Objectives: (1) Establish a best practices guideline for the surgical treatment of primary hyperparathyroidism within the context of single hospital system. (2) Stratify the group of patients who underwent directed excision by the accuracy of preoperative localization studies, and whether intraoperative techniques impacted cure, and at what resource costs.