James Coticchia - Academia.edu (original) (raw)

Papers by James Coticchia

The Ochsner journal, Mar 20, 2016

Background: Formal education about delivering effective handoffs is a known need for residency pr... more Background: Formal education about delivering effective handoffs is a known need for residency programs, and using a standardized process saves time and permits collaboration among programs. To address this need, Wayne State University GME created an institutional intervention on transition-of-care education. After the implementation of the institutional policy, transition-of-care task force members identified a need for monitoring resident handoff quality. For 2012–2013, the task force voted to replicate a 2010 study by Farnan et al by requiring residents to complete an objective simulated handoff evaluation (OSHE). Methods: The task force developed a standardized template to be used by all programs for written handoffs. Each program designed a case and event that junior residents would hand off to senior residents. A total of 82 residents completed the OSHE for a 91% participation rate. Faculty champions hosted a didactic session on transitions of care, secured resident availability, scored the written handoff, and provided resident feedback. Senior residents scored the verbal handoff and gave feedback. Results: Survey results indicated resident confidence in picking up a new service significantly increased (t=2.12, [63], P Conclusions: Institutional educational interventions accomplish several objectives simultaneously. Such interventions are a demonstration of GME engagement and permit policy monitoring that does not detract from the educational focus. The OSHE is a simple but effective tool for sampling how faculty and residents deliver handoffs and provides an ongoing opportunity to refine handoff education.

International Journal of Pediatric Otorhinolaryngology, Feb 1, 2014

Patients with cleft lip and/or palate have higher rates of failure to thrive (FTT), decreased gro... more Patients with cleft lip and/or palate have higher rates of failure to thrive (FTT), decreased growth, and more often experience feeding difficulties as compared with the general pediatric population (J Child Health Care. 2014;18:72-83). Although insufficient nursing, excessive air intake, and incorrect feeding methods have been established in the literature, the role of gastroesophageal reflux disease (GERD) as a contributing factor in cleft patients has not been thoroughly examined. Presently, there is a paucity of literature analyzing the incidence and effect of GERD on this unique population. Furthermore, no studies have evaluated the effect of GERD therapy on improvement of weight gain and FTT in cleft patients. The purpose of this retrospective review was to identify the incidence of GERD in the orofacial cleft population and to see if appropriate treatment was effective in improving weight gain. Fifty patients with cleft lip, cleft lip and palate, and isolated cleft palate were identified from a single surgeon's experience at a large academic medical center from 2015 to 2019. The data show that a significantly higher percentage of patients with cleft lip/and or palate have clinical evidence of GERD, which required treatment as compared with published reports of less than 1% in the noncleft population. The data also suggest that the patients diagnosed with GERD who received pharmacologic treatment showed improved weight gain as compared with those who did not. Given our findings, the diagnosis of GERD should be considered in orofacial cleft patients exhibiting signs of feeding difficulty or those with FTT. The early diagnosis and treatment of GERD in patients with orofacial clefts may improve weight gain.

Archives of Otolaryngology-head & Neck Surgery, Oct 1, 2005

To compare a retrospective cohort of nonhospitalized children with methicillin-resistant Staphylo... more To compare a retrospective cohort of nonhospitalized children with methicillin-resistant Staphylococcus aureus (MRSA) otorrhea with those with methicillin-sensitive S aureus (MSSA) otorrhea to determine the risk factors predisposing to MRSA otorrhea and the treatments used.

Otolaryngology–Head and Neck Surgery, 2007

OBJECTIVES: 1. Identify hemorrhage rates following coblation tonsillectomy. 2. Establish if a lea... more OBJECTIVES: 1. Identify hemorrhage rates following coblation tonsillectomy. 2. Establish if a learning curve exists with the technique with respect to hemorrhage rates. 3. Identify surgeons’ perceptions of the technique with respect to pain and bleed rates. METHODS: Following the Australian National Tonsillectomy Audit of 2005, in early 2006 a supplementary data sheet was sent to all surgeons identified as having experience with coblation for some or all of their tonsillectomies. Hemorrhage events were recorded and surgeons were asked about how they learned the technique and about their perceptions with respect to pain and bleeding rates following coblation tonsillectomy. RESULTS: Data were obtained for 1,740 coblation tonsillectomies with a 70% response rate from targeted surgeons. Inital primary hemorrhage rates were 1.3% initially, falling to 0% with experience (p 0.001; mean 0.3%). Secondary hemorrhage rates were 3.4% initially, falling to 1.0% with experience (p 0.05; mean 2.1%). Only 10% of surgeons attended a formal course or workshop to learn the technique; 65% of surgeons felt the technique was less painful than other methods with only 25% perceiving coblation-produced lower hemorrhage rates. CONCLUSIONS: In Australian practice, the introduction of coblation tonsillectomy occured with a significant learning curve with respect to hemorrhage rates. This can possibly be explained by the low number of surgeons gaining proper experience with the technique prior to performing it on patients. This has implications for the future introduction of new surgical techniques into otolarynology.

Archives of Otolaryngology-head & Neck Surgery, Jul 1, 1999

PubMed, Nov 1, 1986

Peritoneal fluid may be the source of multi-system failure during the initial stages of acute pan... more Peritoneal fluid may be the source of multi-system failure during the initial stages of acute pancreatitis. The toxicity of human pancreatic ascitic fluid (HPAF) collected under sterile conditions from 12 patients with acute pancreatitis was investigated with the use of an in vitro preparation of mitochondria. Hepatocyte mitochondria from Sprague-Dawley rats were prepared by standard techniques. Mitochondrial oxidative activity was determined in glutamate-malate medium, with micromodification of the YSI Model 53 (Yellow Springs, Ohio) oxygen electrode system. The oxygen uptake of 150 to 200 microliter samples of mitochondria suspension (20 to 25 mg/ml) was monitored for 3 minutes, after which 3 microliter of 0.1 M adenosine diphosphate (ADP) was added to the chamber to induce state 3 respiration. Two minutes after the oxygen trace returned to state 4 respirations, 20, 40, or 80 microliter of the HPAF sample was introduced into the reaction vessel and the oxygen measurement continued for an additional 3 minutes. After this, 3 microliter of 0.1 M ADP again was added to the reaction chamber and the oxygen measurement continued. Control runs were made with reconstituted pooled human serum used in place of the HPAF samples. A significant (p less than 0.05) increase in state 4 respiration occurred in all 12 samples of HPAF. Addition of ADP showed a significant decline (p less than 0.05) in respiratory control ratio in all specimens. A dose-response curve was observed in 8 of 12 HPAF samples tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Otolaryngologic Clinics of North America, Feb 1, 1995

Experimental Biology and Medicine, Apr 1, 1983

Acute hemorrhagic pancreatitis (AHP) involves multiple organ failure probably caused by the toxic... more Acute hemorrhagic pancreatitis (AHP) involves multiple organ failure probably caused by the toxic factor(s) released in pancreatitis-associated ascitic fluid (PAAF). We found that PAAF interferes with hepatic mitochondrial respiration resulting in severe disturbances in respiratory control (RCR) and ADP/O ratios. Pancreatitis was induced in dogs by retrograde pancreatic duct infusion and the resultant PAAF was centrifuged, filtered, and frozen until used. Two human PAAFs collected from AHP patients were treated in a similar manner. Rat liver mitochondrial oxygen uptake was measured at 30 degrees C before and after addition of ADP and PAAF. Paired control runs were made using pooled heat-inactivated dog serum. Tests with nine canine PAAFs showed a mean increase of 120% in state 4 respiration (P less than 0.0001). After exposure to PAAF, addition of ADP to previously coupled mitochondria did not induce state 3 respiration. The human PAAFs both showed significant increases in state 4 respiration (P less than 0.01) and a marked decrease in RCR. Dose-response tests with human and canine PAAFs showed a positive correlation between percentage increase in state 4 respiration and the concentration of PAAF used. These results confirm the presence in PAAF of mitotoxic substance(s) which cause irreversible mitochondrial damage. Inhibition of coupled mitochondrial respiration by PAAF with the resultant fall in ATP may be the causative agent for the tissue and organ damage observed in AHP.

Annals of Otology, Rhinology, and Laryngology, Nov 1, 1991

Various biotinylated lectins were used to characterize and semiquantitate glycoconjugate residues... more Various biotinylated lectins were used to characterize and semiquantitate glycoconjugate residues in the tubotympanum. Epithelial goblet cells were stained predominantly by WGA, LFA, SNA, RCA-I, Con-A, LCA, SBA, PHA-E, and UEA; this finding suggests they contain α-neuraminic acid, β-galactose, α-mannose, N-acetyl α-galactosamine, and α-fucose. Glandular mucous cells were stained predominantly by WGA, LFA, SNA, and RCA-I; this finding suggests that they contain α-neuraminic acid and β-galactose. The glandular serous cells were stained predominantly by Con-A, WGA, and LFA; this finding suggests that they produced α-mannose and α-neuraminic acid that represented serum-type glycoprotein. The positive staining of epithelial goblet cells and glandular mucous cells with PNA after neuraminidase digestion suggests that they produced mucin-type glycoproteins. The staining of the mucous blanket by WGA, LFA, SNA, RCA-I, LCA, PNA, SBA, PHA-E, and UEA suggests the presence of α-neuraminic acid, β-galactose, N-acetyl α-galactosamine, and α-fucose. The epithelial cell (nonsecretory) surface was stained largely by WGA, LFA, SNA, RCA-I, Con-A, and LCA; this finding suggests the presence of α-neuramimic acid, β-galactose, and α-mannose.

Otolaryngology-Head and Neck Surgery, Aug 1, 2007

METHODS: Retrospective chart review of 20 children with ages ranging from 2.5 months to 11 years ... more METHODS: Retrospective chart review of 20 children with ages ranging from 2.5 months to 11 years diagnosed with recurrent croup between January 2005 to December 2006. Demographic, historical and intraoperative data as noted in clinic charts were collected. ...

Annals of Otology, Rhinology, and Laryngology, Jul 1, 1993

Previous studies have shown that influenza A virus inoculated via a transbullar approach can caus... more Previous studies have shown that influenza A virus inoculated via a transbullar approach can cause severe disorders of the chinchilla eustachian tube. In this study, we inoculated chinchillas both intranasally and transbullarly with influenza A virus (A/Alaska/6/77) to assess the effect of this virus on both the ciliary activity of eustachian tube epithelium and eustachian tube transport function. Data indicated that while the nature of the major lesions was indistinguishable, the differing routes of inoculation did influence the time course and initial location of virus-induced histopathology. Analysis of ciliary beat frequency and dye transport function indicated a maximal decrease approximately 7 to 14 days postinoculation, with return to normal function by 28 days postinoculation. Light and transmission electron microscopic observations of the evolution of histopathology and return to normal histology correlated well with functional assessment data.

Otolaryngology-Head and Neck Surgery, Aug 1, 2007

METHODS: Comparative micro-anatomic investigation of adenoid mucosa using scanning electron micro... more METHODS: Comparative micro-anatomic investigation of adenoid mucosa using scanning electron microscopy from patients with OME and OSA. Setting: University-affiliated hospitals and ambulatory surgery center. Patients: 10 boys and 10 girls ranging in age from 9 ...

Otolaryngology - Head and Neck Surgery, 2007

The American journal of otology, 1994

In preparation for future implantation of the implantable middle ear transducer in patients, a me... more In preparation for future implantation of the implantable middle ear transducer in patients, a method was sought for preoperatively test fitting a model of the device, using computer generated three-dimensional (3-D) temporal bone images derived from spiral computed tomography (CT) data. A 3-D model of the implantable middle ear transducer was designed using NIH Image software on a Macintosh computer. High resolution human temporal bone CT scans were obtained using a spiral CT scanner (Siemens Somatom Plus S). The 3-D transducer model was superimposed onto 3-D reconstructions of the temporal bone using ANALYZE software on a computer graphics workstation (Sun SPARCstation 10), showing the transducer "implanted" in the temporal bone. Measurements were validated using a cadaver temporal bone. This process produced images demonstrating the "fit" of the current transducer design in the mastoid region of the adult temporal bone. It permitted assessment of the proximity...

The American journal of otology, 1993

The advantages of using a laser to cut a hole in the ossicular chain include increased precision,... more The advantages of using a laser to cut a hole in the ossicular chain include increased precision, decreased likelihood of disarticulation, and elimination of noise-induced threshold shift associated with conventional drills. This study was designed to determine optimal energy settings and cooling technique to minimize tissue injury. Laser ablated holes were cut in rabbit femurs with different endostat fibers at power settings of 1.6 to 5.0 watts. Comparable burr holes were cut by a high-speed drill and the animals were sacrificed at different time intervals. Specimens were evaluated microscopically for tissue injury by the amount of cell necrosis of the surrounding osteocytes, bone marrow changes, and denaturation of bone matrix. Changes in healing were assessed by the production and ossification of the granulation tissue. Laser ablated holes created with 1.6 to 2.0 watts at 2 to 7 days demonstrated thermal damage comparable to conventionally drilled holes. At 14 to 28 days these ho...

Otolaryngology–Head and Neck Surgery, 2013

Objectives:1) Determine if objective tympanometry findings correlate with the subjective endoscop... more Objectives:1) Determine if objective tympanometry findings correlate with the subjective endoscopy finding in diagnosing middle ear disease (AOM or OME) in premature infants. 2) Determine if the incidence of middle ear disease increases with lower gestational weight in premature infants.Methods:Our prospective study includes 76 preterm infants, (< 36wks) admitted to the Neonatal Intensive Care Unit (NICU) at Harper Hospital. Endoscopic otoscopy and tympanometry were performed to detect the presence of otitis media within the first 4 days of birth. The Fisher exact test was used for statistical analysis.Results:1) 44 ears had normal otoendoscopic findings, of which 35 had normal tympanometry findings (79.54 %). 63 ears had middle ear disease, of which 48 showed abnormal reading on tympanometry (76.19 %). 2) 26 babies weighed less than 1300 grams at birth (average gestational age 26.99 weeks), 23 of which had middle ear disease on otoendoscopy. 25 babies weighed more than 1300 gram...

The Ochsner journal, Mar 20, 2016

Background: Formal education about delivering effective handoffs is a known need for residency pr... more Background: Formal education about delivering effective handoffs is a known need for residency programs, and using a standardized process saves time and permits collaboration among programs. To address this need, Wayne State University GME created an institutional intervention on transition-of-care education. After the implementation of the institutional policy, transition-of-care task force members identified a need for monitoring resident handoff quality. For 2012–2013, the task force voted to replicate a 2010 study by Farnan et al by requiring residents to complete an objective simulated handoff evaluation (OSHE). Methods: The task force developed a standardized template to be used by all programs for written handoffs. Each program designed a case and event that junior residents would hand off to senior residents. A total of 82 residents completed the OSHE for a 91% participation rate. Faculty champions hosted a didactic session on transitions of care, secured resident availability, scored the written handoff, and provided resident feedback. Senior residents scored the verbal handoff and gave feedback. Results: Survey results indicated resident confidence in picking up a new service significantly increased (t=2.12, [63], P Conclusions: Institutional educational interventions accomplish several objectives simultaneously. Such interventions are a demonstration of GME engagement and permit policy monitoring that does not detract from the educational focus. The OSHE is a simple but effective tool for sampling how faculty and residents deliver handoffs and provides an ongoing opportunity to refine handoff education.

International Journal of Pediatric Otorhinolaryngology, Feb 1, 2014

Patients with cleft lip and/or palate have higher rates of failure to thrive (FTT), decreased gro... more Patients with cleft lip and/or palate have higher rates of failure to thrive (FTT), decreased growth, and more often experience feeding difficulties as compared with the general pediatric population (J Child Health Care. 2014;18:72-83). Although insufficient nursing, excessive air intake, and incorrect feeding methods have been established in the literature, the role of gastroesophageal reflux disease (GERD) as a contributing factor in cleft patients has not been thoroughly examined. Presently, there is a paucity of literature analyzing the incidence and effect of GERD on this unique population. Furthermore, no studies have evaluated the effect of GERD therapy on improvement of weight gain and FTT in cleft patients. The purpose of this retrospective review was to identify the incidence of GERD in the orofacial cleft population and to see if appropriate treatment was effective in improving weight gain. Fifty patients with cleft lip, cleft lip and palate, and isolated cleft palate were identified from a single surgeon's experience at a large academic medical center from 2015 to 2019. The data show that a significantly higher percentage of patients with cleft lip/and or palate have clinical evidence of GERD, which required treatment as compared with published reports of less than 1% in the noncleft population. The data also suggest that the patients diagnosed with GERD who received pharmacologic treatment showed improved weight gain as compared with those who did not. Given our findings, the diagnosis of GERD should be considered in orofacial cleft patients exhibiting signs of feeding difficulty or those with FTT. The early diagnosis and treatment of GERD in patients with orofacial clefts may improve weight gain.

Archives of Otolaryngology-head & Neck Surgery, Oct 1, 2005

To compare a retrospective cohort of nonhospitalized children with methicillin-resistant Staphylo... more To compare a retrospective cohort of nonhospitalized children with methicillin-resistant Staphylococcus aureus (MRSA) otorrhea with those with methicillin-sensitive S aureus (MSSA) otorrhea to determine the risk factors predisposing to MRSA otorrhea and the treatments used.

Otolaryngology–Head and Neck Surgery, 2007

OBJECTIVES: 1. Identify hemorrhage rates following coblation tonsillectomy. 2. Establish if a lea... more OBJECTIVES: 1. Identify hemorrhage rates following coblation tonsillectomy. 2. Establish if a learning curve exists with the technique with respect to hemorrhage rates. 3. Identify surgeons’ perceptions of the technique with respect to pain and bleed rates. METHODS: Following the Australian National Tonsillectomy Audit of 2005, in early 2006 a supplementary data sheet was sent to all surgeons identified as having experience with coblation for some or all of their tonsillectomies. Hemorrhage events were recorded and surgeons were asked about how they learned the technique and about their perceptions with respect to pain and bleeding rates following coblation tonsillectomy. RESULTS: Data were obtained for 1,740 coblation tonsillectomies with a 70% response rate from targeted surgeons. Inital primary hemorrhage rates were 1.3% initially, falling to 0% with experience (p 0.001; mean 0.3%). Secondary hemorrhage rates were 3.4% initially, falling to 1.0% with experience (p 0.05; mean 2.1%). Only 10% of surgeons attended a formal course or workshop to learn the technique; 65% of surgeons felt the technique was less painful than other methods with only 25% perceiving coblation-produced lower hemorrhage rates. CONCLUSIONS: In Australian practice, the introduction of coblation tonsillectomy occured with a significant learning curve with respect to hemorrhage rates. This can possibly be explained by the low number of surgeons gaining proper experience with the technique prior to performing it on patients. This has implications for the future introduction of new surgical techniques into otolarynology.

Archives of Otolaryngology-head & Neck Surgery, Jul 1, 1999

PubMed, Nov 1, 1986

Peritoneal fluid may be the source of multi-system failure during the initial stages of acute pan... more Peritoneal fluid may be the source of multi-system failure during the initial stages of acute pancreatitis. The toxicity of human pancreatic ascitic fluid (HPAF) collected under sterile conditions from 12 patients with acute pancreatitis was investigated with the use of an in vitro preparation of mitochondria. Hepatocyte mitochondria from Sprague-Dawley rats were prepared by standard techniques. Mitochondrial oxidative activity was determined in glutamate-malate medium, with micromodification of the YSI Model 53 (Yellow Springs, Ohio) oxygen electrode system. The oxygen uptake of 150 to 200 microliter samples of mitochondria suspension (20 to 25 mg/ml) was monitored for 3 minutes, after which 3 microliter of 0.1 M adenosine diphosphate (ADP) was added to the chamber to induce state 3 respiration. Two minutes after the oxygen trace returned to state 4 respirations, 20, 40, or 80 microliter of the HPAF sample was introduced into the reaction vessel and the oxygen measurement continued for an additional 3 minutes. After this, 3 microliter of 0.1 M ADP again was added to the reaction chamber and the oxygen measurement continued. Control runs were made with reconstituted pooled human serum used in place of the HPAF samples. A significant (p less than 0.05) increase in state 4 respiration occurred in all 12 samples of HPAF. Addition of ADP showed a significant decline (p less than 0.05) in respiratory control ratio in all specimens. A dose-response curve was observed in 8 of 12 HPAF samples tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Otolaryngologic Clinics of North America, Feb 1, 1995

Experimental Biology and Medicine, Apr 1, 1983

Acute hemorrhagic pancreatitis (AHP) involves multiple organ failure probably caused by the toxic... more Acute hemorrhagic pancreatitis (AHP) involves multiple organ failure probably caused by the toxic factor(s) released in pancreatitis-associated ascitic fluid (PAAF). We found that PAAF interferes with hepatic mitochondrial respiration resulting in severe disturbances in respiratory control (RCR) and ADP/O ratios. Pancreatitis was induced in dogs by retrograde pancreatic duct infusion and the resultant PAAF was centrifuged, filtered, and frozen until used. Two human PAAFs collected from AHP patients were treated in a similar manner. Rat liver mitochondrial oxygen uptake was measured at 30 degrees C before and after addition of ADP and PAAF. Paired control runs were made using pooled heat-inactivated dog serum. Tests with nine canine PAAFs showed a mean increase of 120% in state 4 respiration (P less than 0.0001). After exposure to PAAF, addition of ADP to previously coupled mitochondria did not induce state 3 respiration. The human PAAFs both showed significant increases in state 4 respiration (P less than 0.01) and a marked decrease in RCR. Dose-response tests with human and canine PAAFs showed a positive correlation between percentage increase in state 4 respiration and the concentration of PAAF used. These results confirm the presence in PAAF of mitotoxic substance(s) which cause irreversible mitochondrial damage. Inhibition of coupled mitochondrial respiration by PAAF with the resultant fall in ATP may be the causative agent for the tissue and organ damage observed in AHP.

Annals of Otology, Rhinology, and Laryngology, Nov 1, 1991

Various biotinylated lectins were used to characterize and semiquantitate glycoconjugate residues... more Various biotinylated lectins were used to characterize and semiquantitate glycoconjugate residues in the tubotympanum. Epithelial goblet cells were stained predominantly by WGA, LFA, SNA, RCA-I, Con-A, LCA, SBA, PHA-E, and UEA; this finding suggests they contain α-neuraminic acid, β-galactose, α-mannose, N-acetyl α-galactosamine, and α-fucose. Glandular mucous cells were stained predominantly by WGA, LFA, SNA, and RCA-I; this finding suggests that they contain α-neuraminic acid and β-galactose. The glandular serous cells were stained predominantly by Con-A, WGA, and LFA; this finding suggests that they produced α-mannose and α-neuraminic acid that represented serum-type glycoprotein. The positive staining of epithelial goblet cells and glandular mucous cells with PNA after neuraminidase digestion suggests that they produced mucin-type glycoproteins. The staining of the mucous blanket by WGA, LFA, SNA, RCA-I, LCA, PNA, SBA, PHA-E, and UEA suggests the presence of α-neuraminic acid, β-galactose, N-acetyl α-galactosamine, and α-fucose. The epithelial cell (nonsecretory) surface was stained largely by WGA, LFA, SNA, RCA-I, Con-A, and LCA; this finding suggests the presence of α-neuramimic acid, β-galactose, and α-mannose.

Otolaryngology-Head and Neck Surgery, Aug 1, 2007

METHODS: Retrospective chart review of 20 children with ages ranging from 2.5 months to 11 years ... more METHODS: Retrospective chart review of 20 children with ages ranging from 2.5 months to 11 years diagnosed with recurrent croup between January 2005 to December 2006. Demographic, historical and intraoperative data as noted in clinic charts were collected. ...

Annals of Otology, Rhinology, and Laryngology, Jul 1, 1993

Previous studies have shown that influenza A virus inoculated via a transbullar approach can caus... more Previous studies have shown that influenza A virus inoculated via a transbullar approach can cause severe disorders of the chinchilla eustachian tube. In this study, we inoculated chinchillas both intranasally and transbullarly with influenza A virus (A/Alaska/6/77) to assess the effect of this virus on both the ciliary activity of eustachian tube epithelium and eustachian tube transport function. Data indicated that while the nature of the major lesions was indistinguishable, the differing routes of inoculation did influence the time course and initial location of virus-induced histopathology. Analysis of ciliary beat frequency and dye transport function indicated a maximal decrease approximately 7 to 14 days postinoculation, with return to normal function by 28 days postinoculation. Light and transmission electron microscopic observations of the evolution of histopathology and return to normal histology correlated well with functional assessment data.

Otolaryngology-Head and Neck Surgery, Aug 1, 2007

METHODS: Comparative micro-anatomic investigation of adenoid mucosa using scanning electron micro... more METHODS: Comparative micro-anatomic investigation of adenoid mucosa using scanning electron microscopy from patients with OME and OSA. Setting: University-affiliated hospitals and ambulatory surgery center. Patients: 10 boys and 10 girls ranging in age from 9 ...

Otolaryngology - Head and Neck Surgery, 2007

The American journal of otology, 1994

In preparation for future implantation of the implantable middle ear transducer in patients, a me... more In preparation for future implantation of the implantable middle ear transducer in patients, a method was sought for preoperatively test fitting a model of the device, using computer generated three-dimensional (3-D) temporal bone images derived from spiral computed tomography (CT) data. A 3-D model of the implantable middle ear transducer was designed using NIH Image software on a Macintosh computer. High resolution human temporal bone CT scans were obtained using a spiral CT scanner (Siemens Somatom Plus S). The 3-D transducer model was superimposed onto 3-D reconstructions of the temporal bone using ANALYZE software on a computer graphics workstation (Sun SPARCstation 10), showing the transducer "implanted" in the temporal bone. Measurements were validated using a cadaver temporal bone. This process produced images demonstrating the "fit" of the current transducer design in the mastoid region of the adult temporal bone. It permitted assessment of the proximity...

The American journal of otology, 1993

The advantages of using a laser to cut a hole in the ossicular chain include increased precision,... more The advantages of using a laser to cut a hole in the ossicular chain include increased precision, decreased likelihood of disarticulation, and elimination of noise-induced threshold shift associated with conventional drills. This study was designed to determine optimal energy settings and cooling technique to minimize tissue injury. Laser ablated holes were cut in rabbit femurs with different endostat fibers at power settings of 1.6 to 5.0 watts. Comparable burr holes were cut by a high-speed drill and the animals were sacrificed at different time intervals. Specimens were evaluated microscopically for tissue injury by the amount of cell necrosis of the surrounding osteocytes, bone marrow changes, and denaturation of bone matrix. Changes in healing were assessed by the production and ossification of the granulation tissue. Laser ablated holes created with 1.6 to 2.0 watts at 2 to 7 days demonstrated thermal damage comparable to conventionally drilled holes. At 14 to 28 days these ho...

Otolaryngology–Head and Neck Surgery, 2013

Objectives:1) Determine if objective tympanometry findings correlate with the subjective endoscop... more Objectives:1) Determine if objective tympanometry findings correlate with the subjective endoscopy finding in diagnosing middle ear disease (AOM or OME) in premature infants. 2) Determine if the incidence of middle ear disease increases with lower gestational weight in premature infants.Methods:Our prospective study includes 76 preterm infants, (< 36wks) admitted to the Neonatal Intensive Care Unit (NICU) at Harper Hospital. Endoscopic otoscopy and tympanometry were performed to detect the presence of otitis media within the first 4 days of birth. The Fisher exact test was used for statistical analysis.Results:1) 44 ears had normal otoendoscopic findings, of which 35 had normal tympanometry findings (79.54 %). 63 ears had middle ear disease, of which 48 showed abnormal reading on tympanometry (76.19 %). 2) 26 babies weighed less than 1300 grams at birth (average gestational age 26.99 weeks), 23 of which had middle ear disease on otoendoscopy. 25 babies weighed more than 1300 gram...