Hassan Ramadan - Academia.edu (original) (raw)

Papers by Hassan Ramadan

Otolaryngology-Head and Neck Surgery, May 1, 1995

Otolaryngology-Head and Neck Surgery, May 1, 1995

Determining adequate staffing levels: Do you have the right number of people to do the work? 2. S... more Determining adequate staffing levels: Do you have the right number of people to do the work? 2. Salary and benefits: What's fair? What's competitive? What are other surgeons doing? 3. Evaluation: Are you effectively giving performance appraisals or is this hit and miss? 4. Delegation: Tips for having staff work at the highest productivity level.

Otolaryngology-Head and Neck Surgery, Aug 1, 1995

Otolaryngology-Head and Neck Surgery, Aug 1, 1996

To determine when a maxillary sinus puncture is indicated and whether it has an impact on outcome... more To determine when a maxillary sinus puncture is indicated and whether it has an impact on outcome in patients in the intensive care unit (ICU).

Journal of PeriAnesthesia Nursing, 2014

Introduction: Research demonstrates registered nurses who provide direct patient care are well po... more Introduction: Research demonstrates registered nurses who provide direct patient care are well poised to design systems and processes to accomplish the goals of safe quality care. However, many processes of patient care are richly steeped in tradition and are not evidence-based. Identification of the Problem: One long-standing tradition in our organization centers on discharging tonsillectomy patients using a "pre-specified period of time" (360 minutes). The presumption is using a "pre-specified time" provides ample opportunity for patients to recovery. This current practice has resulted in inefficiency, increased hospital cost, and a decrease in patient satisfaction.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2015

Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the p... more Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the precise pathophysiologic mechanism of this interaction is still poorly understood, especially in children, owing to the lack of direct measurements of mucosal inflammation in the upper airways. To determine the pathophysiologic mechanism by analyzing the expression of a large array of inflammatory cytokines and chemokines in the sinus and adenoid tissues surgically removed from pediatric patients with CRS refractory to medical management. Twenty-eight children 2 to 12 years old diagnosed with CRS with or without asthma and 10 controls were included in this prospective, nonrandomized study. Mucosal expression of 40 inflammatory cytokines was measured with a multiplex assay and was normalized to total tissue protein. Compared with children with CRS and without asthma, children with CRS and asthma had significantly higher sinus levels of tumor necrosis factor-α and adenoid levels of epiderma...

PEDIATRICS, 2008

Ramadan HH, Tiu J. Laryngoscope. 2007;117(6):1080–1083 PURPOSE OF THE STUDY. To determine which c... more Ramadan HH, Tiu J. Laryngoscope. 2007;117(6):1080–1083 PURPOSE OF THE STUDY. To determine which children who undergo adenoidectomy for chronic rhinosinusitis will subsequently undergo endoscopic sinus surgery. STUDY POPULATION. Children who had adenoidectomy for treatment of refractory chronic rhinosinusitis over a 10-year period at a tertiary pediatric facility were included in the study. Excluded children were those with immunodeficiency, cystic fibrosis, or previous sinus surgery. All patients had an extensive preoperative workup to rule out allergy, immunodeficiency, and cystic fibrosis. METHODS. Charts were reviewed, and data were collected retrospectively. All patients underwent adenoidectomy via the suction electrocautery technique. Children were followed monthly for 3 months after adenoidectomy and then every 3 months. Data collected included age, presence of allergy or asthma, severity of sinusitis as indicated on computed tomography (CT) scans, and dates of adenoidectomy a...

Otolaryngology - Head and Neck Surgery, 2000

INTRODUCTION: Rhinosinusitis is a common disease affecting an estimated 14% of the population. Al... more INTRODUCTION: Rhinosinusitis is a common disease affecting an estimated 14% of the population. Although there is general agreement in the literature regarding acute rhinosinusitis, chronic rhinosinusitis is not as well studied, and no consensus has been reached regarding the bacterial etiology. The goal of this study was to test chronic rhinosinusitis mucosal specimens using the polymerase chain reaction (PCR) for aerobic bacterial content and to compare the results with standard culture data. RESULTS: Routine culture samples grew 50% aerobic bacteria, whereas PCR detected 62% aerobic bacteria contamination. CONCLUSION: PCR detected more bacteria in mucosal samples than in standard culture, but standard culture of this mucosa reflects the general aerobic bacteria found in chronic rhinosinusitis, with no predominant species of aerobic bacteria. SIGNIFICANCE: The analysis of chronic rhinosinusitis mucosa with the PCR method should give a more accurate picture of the bacteria found in ...

Archives of Otolaryngology–Head & Neck Surgery, 2003

To determine whether endoscopic sinus surgery (ESS) in children has a better outcome at a certain... more To determine whether endoscopic sinus surgery (ESS) in children has a better outcome at a certain age. Design and Setting: Cohort study in a tertiary care children's hospital.

PEDIATRICS, 2008

Ramadan HH, Cost JL. Laryngoscope. 2008;118(5):871–873 PURPOSE OF THE STUDY. To compare the outco... more Ramadan HH, Cost JL. Laryngoscope. 2008;118(5):871–873 PURPOSE OF THE STUDY. To compare the outcomes of adenoidectomy with adenoidectomy combined with maxillary sinus wash for the treatment of children with medically refractory sinusitis. STUDY POPULATION. Studied were children treated at a tertiary otolaryngology referral center with chronic (>6 months) or recurrent (>6 episodes) rhinosinusitis diagnosed by both clinical criteria and computed tomography (CT) who did not improve with 6 months of treatment with oral antibiotics, decongestants, and allergy management when appropriate. Children with cystic fibrosis, immunoglobulin deficiency, ciliary dysfunction, or a history of previous adenoid or sinus surgery were excluded. METHODS. Patients were assigned to adenoidectomy alone or adenoidectomy in combination with maxillary sinus wash in a nonrandomized manner on the basis of surgeon and parental preference. A questionnaire was administered 12 months after surgery to evaluate ...

American Journal of Rhinology, 2006

Background Allergic rhinitis (AR) is a morbid condition in children with chronic rhinosinusitis. ... more Background Allergic rhinitis (AR) is a morbid condition in children with chronic rhinosinusitis. The study goal was to determine whether children with AR who are undergoing endoscopic sinus surgery (ESS) will have a poor outcome. Methods The study population consisted of141 patients who underwent ESS between January 1994 and December 2002. The outcome of ESS was measured at least 1 year after the operation. Results The overall success rate was 80%. Children with an allergy had 77% success rate compared with children with no allergy who had an 84% success rate (p = 0.25). Children with AR who were on treatment before surgery had an 84% success rate compared with 62% for those children with AR but were not treated (p = 0.022). Conclusion ESS in children with AR does not have a poorer outcome. Treatment of the allergy before surgery may improve the success of ESS.

Supplemental material, Appendix_A for A Multicenter, Cross-Sectional Assessment of Otolaryngology... more Supplemental material, Appendix_A for A Multicenter, Cross-Sectional Assessment of Otolaryngology Knowledge Among Primary Care Trainees by Daniel C. O'Brien, Lane D. Squires, Aaron D. Robinson, Hassan Ramadan and Rodney Diaz in Annals of Otology, Rhinology & Laryngology

Ear, Nose & Throat Journal, 2019

The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplas... more The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplasty in the treatment of pediatric chronic maxillary sinusitis following failed first-line medical and surgical management with adenoidectomy. Pediatric patients younger than 12 years were reviewed for having failed previous adenoidectomy and undergone a balloon catheter sinuplasty between August 2006 and March 2011 for chronic rhinosinusitis. Demographic data and clinical characteristics were recorded in patients who met inclusion criteria. Outcomes were assessed by need for functional endoscopic sinus surgery and persistence of chronic infection within at least 5 years of follow-up. Failure was defined by any child who was rediagnosed with chronic sinus disease after balloon catheter sinuplasty or who required endoscopic sinus surgery within 5 years. Sixty-two children were reviewed, with 38 patients meeting inclusion criteria (prior adenoidectomy, a preoperative Lund-Mackay score of ≥5,...

Ear, Nose & Throat Journal, 2019

The purpose of this article is to differentiate pediatric patients with chronic adenoiditis from ... more The purpose of this article is to differentiate pediatric patients with chronic adenoiditis from those with chronic rhinosinusitis (CRS) based on presenting symptoms. A chart review from a tertiary care facility with pediatric patients who presented with suspected CRS from 2006 to 2014 was identified. We compared patient characteristics, clinical symptoms, duration of symptoms, and past medial history using univariate and multivariate logistic regression models. Based on recent literature, utilizing the computed tomography (CT) score, we identified those children with CRS versus those with chronic adenoiditis. Of the 99 pediatric patients included, 22 patients had diagnosis of adenoiditis and 77 had diagnosis of CRS. When purulent rhinorrhea was present with facial pain, CRS was statistically more prevalent than chronic adenoiditis ( P = .017). Symptoms including cough ( P = .022), rhinorrhea ( P = .27), and facial pressure ( P = .98) were not predictive of one diagnosis over the ot...

Case reports in otolaryngology, 2018

To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutan... more To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutaneous fistula and to review management strategies. A tracheocutaneous fistula is a common sequela of pediatric tracheostomy and can occur in as many as one in three pediatric patients. There is debate in the literature regarding optimal surgical management. An 8-year-old girl presented to the emergency department with swelling and erythema over the anterior neck. Clinical exam and diagnostic imaging revealed an underlying tracheocutaneous sinus. Complications following pediatric tracheostomy are common and range in complexity from stomal granulation to tracheocutaneous fistula. There is some debate regarding the optimal surgical management of children with tracheocutaneous fistula following tracheostomy. This report discusses the management of a pediatric child with an unusual tracheocutaneous sinus and reviews the various surgical techniques which have been described for definitive repair.

The American Journal of Cosmetic Surgery, 2017

Ensuring adequate intraoperative hemostasis is crucial in avoiding serious complications of rhyti... more Ensuring adequate intraoperative hemostasis is crucial in avoiding serious complications of rhytidectomy surgery such as hematoma formation and skin flap necrosis. Charring of bipolar electrocautery arms can lead to ineffective hemostasis, frequent wiping to ensure hemostatic efficacy and prolonged operative time. We investigate the impact of a commercially available antistick coating solution (Electro Lube) on intraoperative wiping frequency of bipolar electrocautery arms and operative time for rhytidectomy procedures. Fifty patients undergoing rhytidectomy were prospectively enrolled in a randomized, split-face study. All patients enrolled were seen and evaluated in a private facial plastic and reconstructive surgery practice, and were operated on by a single surgeon in either an accredited ambulatory surgical center under deep, intravenous sedation or in a monitored office setting under light, oral sedation. Electro Lube was utilized to coat bipolar electrocautery arms for one si...

Annals of Otology, Rhinology & Laryngology, 2010

Objectives Adenoidectomy is the first step in the surgical management of children with chronic rh... more Objectives Adenoidectomy is the first step in the surgical management of children with chronic rhinosinusitis (CRS). Adenoidectomy, however, is only effective in half of these children. Although endoscopic sinus surgery is effective for CRS, there is concern for facial growth retardation and major complications. We propose that balloon catheter sinuplasty (BCS) is a minimally invasive, effective procedure in the treatment of pediatric CRS. Methods We undertook a nonrandomized, controlled, prospective review of children with failed medical management of CRS who underwent BCS or adenoidectomy. Outcomes were assessed at 1 year of follow-up and were based on SN-5 scores and the need for revision surgery. Results Forty-nine children who satisfied the inclusion criteria were reviewed. Thirty of the children had BCS. The age range was 4 to 11 years (mean, 7.7 years), and the mean computed tomography score (Lund-Mackay system) was 7.5. Twenty-four of the 30 patients (80%) who underwent BCS ...

International forum of allergy & rhinology, 2016

Isam Alobid, MD, PhD(1) , Nithin D. Adappa, MD(2) , Henry P. Barham, MD(3) , Thiago Bezerra, MD(4... more Isam Alobid, MD, PhD(1) , Nithin D. Adappa, MD(2) , Henry P. Barham, MD(3) , Thiago Bezerra, MD(4) , Nadieska Caballero, MD(5) , Eugene G. Chang, MD(6) , Gaurav Chawdhary, MD(7) , Philip Chen, MD(8) , John P. Dahl, MD, PhD(9) , Anthony Del Signore, MD(10) , Carrie Flanagan, MD(11) , Daniel N. Frank, PhD(12) , Kai Fruth, MD, PhD(13) , Anne Getz, MD(14) , Samuel Greig, MD(15) , Elisa A. Illing, MD(16) , David W. Jang, MD(17) , Yong Gi Jung, MD(18) , Sammy Khalili, MD, MSc(19) , Cristobal Langdon, MD(20) , Kent Lam, MD(21) , Stella Lee, MD(22) , Seth Lieberman, MD(23) , Patricia Loftus, MD(24) , Luis Macias-Valle, MD(25) , R. Peter Manes, MD(26) , Jill Mazza, MD(27) , Leandra Mfuna, MD(28) , David Morrissey, MD(29) , Sue Jean Mun, MD(30) , Jonathan B. Overdevest, MD, PhD(31) , Jayant M. Pinto, MD(32) , Jain Ravi, MD(33) , Douglas Reh, MD(34) , Peta L. Sacks, MD(35) , Michael H. Saste, MD(36) , John Schneider, MD, MA(37) , Ahmad R. Sedaghat, MD, PhD(38) , Zachary M. Soler, MD(39) , Nevi...

JAMA otolaryngology-- head & neck surgery, Jan 4, 2016

Tonsillectomy is among the most common surgical procedures performed by general and pediatric oto... more Tonsillectomy is among the most common surgical procedures performed by general and pediatric otolaryngologists. Inpatient surgery is generally recommended for children 36 months and younger owing to concern for a higher incidence of postoperative complications. To ascertain the need for a planned inpatient stay for extracapsular tonsillectomy in children 36 months and younger . Retrospective medical record review of patients 36 months and younger who underwent inpatient extracapsular tonsillectomy or adenotonsillectomy at a tertiary care academic institution from January 2009 to September 2014. Of 279 medical records reviewed, 188 met the inclusion criteria for the study. Extracapsular tonsillectomy. Inpatient notes, discharge summaries, and postoperative clinic visit notes in the electronic medical record were reviewed for information about complications occurring during postoperative inpatient hospitalization. Specifically, the incidence of postoperative hemorrhage, postoperative...

Otolaryngology -- Head and Neck Surgery, 2014

Objectives: Sleep-disordered breathing (SDB) affects approximately 12% of children, ranging from ... more Objectives: Sleep-disordered breathing (SDB) affects approximately 12% of children, ranging from snoring to obstructive sleep apnea (OSA). Polysomnography (PSG) is the gold standard for diagnosing SDB and has been increasingly obtained in children. Some feel PSG is underutilized given recent clinical guidelines; however, others believe that if the clinical indicators for OSA are present, a PSG is unnecessary. The purpose of this study was to determine the effectiveness of clinical indicators in predicting PSG results in children. Methods: A retrospective review of PSG on children between 2 and 18 years old ordered by an otolaryngologist at West Virginia University between January 2011 and November 2013. Recorded variables included: age, sex, symptoms of gasping, snoring, restlessness, body mass index, previous adenoidectomy, tonsil size, and apnea-hypopnea index (AHI). Statistical analysis was used to compare positive PSG with clinical indicators. Results: Ninety-five patients were ...

Otolaryngology-Head and Neck Surgery, May 1, 1995

Otolaryngology-Head and Neck Surgery, May 1, 1995

Determining adequate staffing levels: Do you have the right number of people to do the work? 2. S... more Determining adequate staffing levels: Do you have the right number of people to do the work? 2. Salary and benefits: What's fair? What's competitive? What are other surgeons doing? 3. Evaluation: Are you effectively giving performance appraisals or is this hit and miss? 4. Delegation: Tips for having staff work at the highest productivity level.

Otolaryngology-Head and Neck Surgery, Aug 1, 1995

Otolaryngology-Head and Neck Surgery, Aug 1, 1996

To determine when a maxillary sinus puncture is indicated and whether it has an impact on outcome... more To determine when a maxillary sinus puncture is indicated and whether it has an impact on outcome in patients in the intensive care unit (ICU).

Journal of PeriAnesthesia Nursing, 2014

Introduction: Research demonstrates registered nurses who provide direct patient care are well po... more Introduction: Research demonstrates registered nurses who provide direct patient care are well poised to design systems and processes to accomplish the goals of safe quality care. However, many processes of patient care are richly steeped in tradition and are not evidence-based. Identification of the Problem: One long-standing tradition in our organization centers on discharging tonsillectomy patients using a "pre-specified period of time" (360 minutes). The presumption is using a "pre-specified time" provides ample opportunity for patients to recovery. This current practice has resulted in inefficiency, increased hospital cost, and a decrease in patient satisfaction.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2015

Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the p... more Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the precise pathophysiologic mechanism of this interaction is still poorly understood, especially in children, owing to the lack of direct measurements of mucosal inflammation in the upper airways. To determine the pathophysiologic mechanism by analyzing the expression of a large array of inflammatory cytokines and chemokines in the sinus and adenoid tissues surgically removed from pediatric patients with CRS refractory to medical management. Twenty-eight children 2 to 12 years old diagnosed with CRS with or without asthma and 10 controls were included in this prospective, nonrandomized study. Mucosal expression of 40 inflammatory cytokines was measured with a multiplex assay and was normalized to total tissue protein. Compared with children with CRS and without asthma, children with CRS and asthma had significantly higher sinus levels of tumor necrosis factor-α and adenoid levels of epiderma...

PEDIATRICS, 2008

Ramadan HH, Tiu J. Laryngoscope. 2007;117(6):1080–1083 PURPOSE OF THE STUDY. To determine which c... more Ramadan HH, Tiu J. Laryngoscope. 2007;117(6):1080–1083 PURPOSE OF THE STUDY. To determine which children who undergo adenoidectomy for chronic rhinosinusitis will subsequently undergo endoscopic sinus surgery. STUDY POPULATION. Children who had adenoidectomy for treatment of refractory chronic rhinosinusitis over a 10-year period at a tertiary pediatric facility were included in the study. Excluded children were those with immunodeficiency, cystic fibrosis, or previous sinus surgery. All patients had an extensive preoperative workup to rule out allergy, immunodeficiency, and cystic fibrosis. METHODS. Charts were reviewed, and data were collected retrospectively. All patients underwent adenoidectomy via the suction electrocautery technique. Children were followed monthly for 3 months after adenoidectomy and then every 3 months. Data collected included age, presence of allergy or asthma, severity of sinusitis as indicated on computed tomography (CT) scans, and dates of adenoidectomy a...

Otolaryngology - Head and Neck Surgery, 2000

INTRODUCTION: Rhinosinusitis is a common disease affecting an estimated 14% of the population. Al... more INTRODUCTION: Rhinosinusitis is a common disease affecting an estimated 14% of the population. Although there is general agreement in the literature regarding acute rhinosinusitis, chronic rhinosinusitis is not as well studied, and no consensus has been reached regarding the bacterial etiology. The goal of this study was to test chronic rhinosinusitis mucosal specimens using the polymerase chain reaction (PCR) for aerobic bacterial content and to compare the results with standard culture data. RESULTS: Routine culture samples grew 50% aerobic bacteria, whereas PCR detected 62% aerobic bacteria contamination. CONCLUSION: PCR detected more bacteria in mucosal samples than in standard culture, but standard culture of this mucosa reflects the general aerobic bacteria found in chronic rhinosinusitis, with no predominant species of aerobic bacteria. SIGNIFICANCE: The analysis of chronic rhinosinusitis mucosa with the PCR method should give a more accurate picture of the bacteria found in ...

Archives of Otolaryngology–Head & Neck Surgery, 2003

To determine whether endoscopic sinus surgery (ESS) in children has a better outcome at a certain... more To determine whether endoscopic sinus surgery (ESS) in children has a better outcome at a certain age. Design and Setting: Cohort study in a tertiary care children's hospital.

PEDIATRICS, 2008

Ramadan HH, Cost JL. Laryngoscope. 2008;118(5):871–873 PURPOSE OF THE STUDY. To compare the outco... more Ramadan HH, Cost JL. Laryngoscope. 2008;118(5):871–873 PURPOSE OF THE STUDY. To compare the outcomes of adenoidectomy with adenoidectomy combined with maxillary sinus wash for the treatment of children with medically refractory sinusitis. STUDY POPULATION. Studied were children treated at a tertiary otolaryngology referral center with chronic (>6 months) or recurrent (>6 episodes) rhinosinusitis diagnosed by both clinical criteria and computed tomography (CT) who did not improve with 6 months of treatment with oral antibiotics, decongestants, and allergy management when appropriate. Children with cystic fibrosis, immunoglobulin deficiency, ciliary dysfunction, or a history of previous adenoid or sinus surgery were excluded. METHODS. Patients were assigned to adenoidectomy alone or adenoidectomy in combination with maxillary sinus wash in a nonrandomized manner on the basis of surgeon and parental preference. A questionnaire was administered 12 months after surgery to evaluate ...

American Journal of Rhinology, 2006

Background Allergic rhinitis (AR) is a morbid condition in children with chronic rhinosinusitis. ... more Background Allergic rhinitis (AR) is a morbid condition in children with chronic rhinosinusitis. The study goal was to determine whether children with AR who are undergoing endoscopic sinus surgery (ESS) will have a poor outcome. Methods The study population consisted of141 patients who underwent ESS between January 1994 and December 2002. The outcome of ESS was measured at least 1 year after the operation. Results The overall success rate was 80%. Children with an allergy had 77% success rate compared with children with no allergy who had an 84% success rate (p = 0.25). Children with AR who were on treatment before surgery had an 84% success rate compared with 62% for those children with AR but were not treated (p = 0.022). Conclusion ESS in children with AR does not have a poorer outcome. Treatment of the allergy before surgery may improve the success of ESS.

Supplemental material, Appendix_A for A Multicenter, Cross-Sectional Assessment of Otolaryngology... more Supplemental material, Appendix_A for A Multicenter, Cross-Sectional Assessment of Otolaryngology Knowledge Among Primary Care Trainees by Daniel C. O'Brien, Lane D. Squires, Aaron D. Robinson, Hassan Ramadan and Rodney Diaz in Annals of Otology, Rhinology & Laryngology

Ear, Nose & Throat Journal, 2019

The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplas... more The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplasty in the treatment of pediatric chronic maxillary sinusitis following failed first-line medical and surgical management with adenoidectomy. Pediatric patients younger than 12 years were reviewed for having failed previous adenoidectomy and undergone a balloon catheter sinuplasty between August 2006 and March 2011 for chronic rhinosinusitis. Demographic data and clinical characteristics were recorded in patients who met inclusion criteria. Outcomes were assessed by need for functional endoscopic sinus surgery and persistence of chronic infection within at least 5 years of follow-up. Failure was defined by any child who was rediagnosed with chronic sinus disease after balloon catheter sinuplasty or who required endoscopic sinus surgery within 5 years. Sixty-two children were reviewed, with 38 patients meeting inclusion criteria (prior adenoidectomy, a preoperative Lund-Mackay score of ≥5,...

Ear, Nose & Throat Journal, 2019

The purpose of this article is to differentiate pediatric patients with chronic adenoiditis from ... more The purpose of this article is to differentiate pediatric patients with chronic adenoiditis from those with chronic rhinosinusitis (CRS) based on presenting symptoms. A chart review from a tertiary care facility with pediatric patients who presented with suspected CRS from 2006 to 2014 was identified. We compared patient characteristics, clinical symptoms, duration of symptoms, and past medial history using univariate and multivariate logistic regression models. Based on recent literature, utilizing the computed tomography (CT) score, we identified those children with CRS versus those with chronic adenoiditis. Of the 99 pediatric patients included, 22 patients had diagnosis of adenoiditis and 77 had diagnosis of CRS. When purulent rhinorrhea was present with facial pain, CRS was statistically more prevalent than chronic adenoiditis ( P = .017). Symptoms including cough ( P = .022), rhinorrhea ( P = .27), and facial pressure ( P = .98) were not predictive of one diagnosis over the ot...

Case reports in otolaryngology, 2018

To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutan... more To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutaneous fistula and to review management strategies. A tracheocutaneous fistula is a common sequela of pediatric tracheostomy and can occur in as many as one in three pediatric patients. There is debate in the literature regarding optimal surgical management. An 8-year-old girl presented to the emergency department with swelling and erythema over the anterior neck. Clinical exam and diagnostic imaging revealed an underlying tracheocutaneous sinus. Complications following pediatric tracheostomy are common and range in complexity from stomal granulation to tracheocutaneous fistula. There is some debate regarding the optimal surgical management of children with tracheocutaneous fistula following tracheostomy. This report discusses the management of a pediatric child with an unusual tracheocutaneous sinus and reviews the various surgical techniques which have been described for definitive repair.

The American Journal of Cosmetic Surgery, 2017

Ensuring adequate intraoperative hemostasis is crucial in avoiding serious complications of rhyti... more Ensuring adequate intraoperative hemostasis is crucial in avoiding serious complications of rhytidectomy surgery such as hematoma formation and skin flap necrosis. Charring of bipolar electrocautery arms can lead to ineffective hemostasis, frequent wiping to ensure hemostatic efficacy and prolonged operative time. We investigate the impact of a commercially available antistick coating solution (Electro Lube) on intraoperative wiping frequency of bipolar electrocautery arms and operative time for rhytidectomy procedures. Fifty patients undergoing rhytidectomy were prospectively enrolled in a randomized, split-face study. All patients enrolled were seen and evaluated in a private facial plastic and reconstructive surgery practice, and were operated on by a single surgeon in either an accredited ambulatory surgical center under deep, intravenous sedation or in a monitored office setting under light, oral sedation. Electro Lube was utilized to coat bipolar electrocautery arms for one si...

Annals of Otology, Rhinology & Laryngology, 2010

Objectives Adenoidectomy is the first step in the surgical management of children with chronic rh... more Objectives Adenoidectomy is the first step in the surgical management of children with chronic rhinosinusitis (CRS). Adenoidectomy, however, is only effective in half of these children. Although endoscopic sinus surgery is effective for CRS, there is concern for facial growth retardation and major complications. We propose that balloon catheter sinuplasty (BCS) is a minimally invasive, effective procedure in the treatment of pediatric CRS. Methods We undertook a nonrandomized, controlled, prospective review of children with failed medical management of CRS who underwent BCS or adenoidectomy. Outcomes were assessed at 1 year of follow-up and were based on SN-5 scores and the need for revision surgery. Results Forty-nine children who satisfied the inclusion criteria were reviewed. Thirty of the children had BCS. The age range was 4 to 11 years (mean, 7.7 years), and the mean computed tomography score (Lund-Mackay system) was 7.5. Twenty-four of the 30 patients (80%) who underwent BCS ...

International forum of allergy & rhinology, 2016

Isam Alobid, MD, PhD(1) , Nithin D. Adappa, MD(2) , Henry P. Barham, MD(3) , Thiago Bezerra, MD(4... more Isam Alobid, MD, PhD(1) , Nithin D. Adappa, MD(2) , Henry P. Barham, MD(3) , Thiago Bezerra, MD(4) , Nadieska Caballero, MD(5) , Eugene G. Chang, MD(6) , Gaurav Chawdhary, MD(7) , Philip Chen, MD(8) , John P. Dahl, MD, PhD(9) , Anthony Del Signore, MD(10) , Carrie Flanagan, MD(11) , Daniel N. Frank, PhD(12) , Kai Fruth, MD, PhD(13) , Anne Getz, MD(14) , Samuel Greig, MD(15) , Elisa A. Illing, MD(16) , David W. Jang, MD(17) , Yong Gi Jung, MD(18) , Sammy Khalili, MD, MSc(19) , Cristobal Langdon, MD(20) , Kent Lam, MD(21) , Stella Lee, MD(22) , Seth Lieberman, MD(23) , Patricia Loftus, MD(24) , Luis Macias-Valle, MD(25) , R. Peter Manes, MD(26) , Jill Mazza, MD(27) , Leandra Mfuna, MD(28) , David Morrissey, MD(29) , Sue Jean Mun, MD(30) , Jonathan B. Overdevest, MD, PhD(31) , Jayant M. Pinto, MD(32) , Jain Ravi, MD(33) , Douglas Reh, MD(34) , Peta L. Sacks, MD(35) , Michael H. Saste, MD(36) , John Schneider, MD, MA(37) , Ahmad R. Sedaghat, MD, PhD(38) , Zachary M. Soler, MD(39) , Nevi...

JAMA otolaryngology-- head & neck surgery, Jan 4, 2016

Tonsillectomy is among the most common surgical procedures performed by general and pediatric oto... more Tonsillectomy is among the most common surgical procedures performed by general and pediatric otolaryngologists. Inpatient surgery is generally recommended for children 36 months and younger owing to concern for a higher incidence of postoperative complications. To ascertain the need for a planned inpatient stay for extracapsular tonsillectomy in children 36 months and younger . Retrospective medical record review of patients 36 months and younger who underwent inpatient extracapsular tonsillectomy or adenotonsillectomy at a tertiary care academic institution from January 2009 to September 2014. Of 279 medical records reviewed, 188 met the inclusion criteria for the study. Extracapsular tonsillectomy. Inpatient notes, discharge summaries, and postoperative clinic visit notes in the electronic medical record were reviewed for information about complications occurring during postoperative inpatient hospitalization. Specifically, the incidence of postoperative hemorrhage, postoperative...

Otolaryngology -- Head and Neck Surgery, 2014

Objectives: Sleep-disordered breathing (SDB) affects approximately 12% of children, ranging from ... more Objectives: Sleep-disordered breathing (SDB) affects approximately 12% of children, ranging from snoring to obstructive sleep apnea (OSA). Polysomnography (PSG) is the gold standard for diagnosing SDB and has been increasingly obtained in children. Some feel PSG is underutilized given recent clinical guidelines; however, others believe that if the clinical indicators for OSA are present, a PSG is unnecessary. The purpose of this study was to determine the effectiveness of clinical indicators in predicting PSG results in children. Methods: A retrospective review of PSG on children between 2 and 18 years old ordered by an otolaryngologist at West Virginia University between January 2011 and November 2013. Recorded variables included: age, sex, symptoms of gasping, snoring, restlessness, body mass index, previous adenoidectomy, tonsil size, and apnea-hypopnea index (AHI). Statistical analysis was used to compare positive PSG with clinical indicators. Results: Ninety-five patients were ...