Robert Ossoff - Academia.edu (original) (raw)

Papers by Robert Ossoff

The Annals of otology, rhinology, and laryngology, 2007

We developed and validated a disorder-specific health status instrument (Singing Voice Handicap I... more We developed and validated a disorder-specific health status instrument (Singing Voice Handicap Index; SVHI) for use in patients with singing problems. Prospective instrument validation was performed. Of 81 original items, those with poor statistical validity were eliminated, resulting in 36 items. The ability to discriminate dysphonic from normal singers, test-retest reliability, internal consistency, and construct validity were assessed. We included 112 dysphonic and 129 normal singers, professional and nonprofessional, of classical, country, rock, choral, and gospel repertoire. Dysphonic singers had worse SVHI scores than normal singers (p < or = .001, rank sum test). Test-retest reliability was high (Spearman correlation, 0.92; p < or = .001). Internal consistency demonstrated a Cronbach's alpha of .97, and the correlation between the SVHI and self-rated singing voice impairment was .63 (p < or = .001, Spearman correlation). The SVHI is a reliable and valid tool for...

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

Laryngoscope, 1997

A survey was conducted to identify demographics and standards of care for treatment of hypopharyn... more A survey was conducted to identify demographics and standards of care for treatment of hypopharyngeal squamous cell carcinoma in the United States. Data were accrued from voluntary submission of cancer registry and medical chart information from 769 hospitals representing 2939 cases diagnosed from 1980 to 1986 and 1990 to 1992. Clinical findings, diagnostic procedures employed, treatment practices, and outcome are presented. Overall, 6-year disease-specific survival was 33.4%, which segregated to 63.1% (stage I), 67.6% (stage 111, 41.8% (stage 1111, and 22% (stage IV). Survival was best for patients treated with surgery only (60.4%), similar with combined surgery and irradiation (48%), and worse with irradiation only (26.8%). This analysis provides a standard to which current treatment practice and future clinical trials may be compared.

Public reporting burden for this collection of information is estimated to average 1 hour per res... more Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project (0704-0188), Washington, DC 20503.

Survey of Anesthesiology, 1985

Studies were undertaken by the Departments of Otolaryngology-Head and Neck Surgery and Anesthesio... more Studies were undertaken by the Departments of Otolaryngology-Head and Neck Surgery and Anesthesiology at Northwestern University Medical School and the Medical College of Wisconsin (Milwaukee) to compare the potential for tissue injury to the trachea and lungs of canines. Polyvinylchloride (PVC), Rusch red rubber, and silicone tubes were tested. The effects of an intraluminal tube fire on the larynx and trachea were documented with laryngeal and bronchoscopic photographs taken immediately postburn and at the time of sacrifice six hours later. The most severe burns were associated with the PVC tube. Silica ash was seen in the airway after the silicone tube fires and raises the possibility of future problems with silicosis. Histological examination of the trachea showed acute injury in all of the animals; specimens from the dogs with the PVC tube fires demonstrated the most severe cellular damage.

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

The newer generation micromanipulators for the carbon d ioxide laser were introduced in 1987. The... more The newer generation micromanipulators for the carbon d ioxide laser were introduced in 1987. These newer generation micromanipulators are capable of providing laser spot sizes of 300 urn or less at a focal length of 400 mm. In addition to providing a smaller spot size than prior generation micromanipulators, these newer generation instruments also eliminate the parallax aiming error that is present when the mirror is mounted offset from the optical path from the microscope. Because of these two technological advances, COzlaser use has expanded into the pediatric field. Smaller spot sizes have allowed for greater precision for ablation and have allowed application in areas of very limited surgical exposure. Applications include microtrapdoor flap for subglottic stenosis scar treatment, and adjunctive ablation of granulation and scar in choanal atresia repair.

The Laryngoscope, Jan 3, 2015

A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplaki... more A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplakia therapeutically decreased dysplasia grade. The current investigation aimed to 1) analyze the pathological evolution and natural history of these lesions and 2) re-examine the role of serial excisions in dysplasia grade regression in long-term follow-up. Retrospective case series. Patients treated for vocal fold dysplasia (1994-2013) with serial full-thickness microflap-type excisions were identified and followed longitudinally. Excluded were those with one excision, invasive cancer at initial excision, or history of laryngeal cancer or radiation. Data from surgical procedures, associated pathology, and patient characteristics were recorded. Weighted repeated measures ordinal logistic regression measured associations with pathology findings. Of 55 patients (median age = 65 years, interquartile range = 54-73 years, 89% male, 63% ever smokers, 27% alcohol users), 31 met inclusion criteria...

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1993

The Annals of otology, rhinology, and laryngology, 1995

Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina pro... more Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina propria must permit the preservation and/or restoration of VF vibratory characteristics. The endoscopic VF microflap is designed to do such. A retrospective study was undertaken to evaluate the efficacy of this procedure. Forty microflaps (7 bilateral, 1 revision) were performed on 32 patients. Charts and surgical pathology findings were reviewed. Preoperative and 3-month postoperative video recorded voice samples and stroboscopic examination results were compared. Findings on perceptual voice analysis did not significantly change. Stroboscopic examinations revealed improved postoperative VF closure in 27 of 29 patients with impaired preoperative closure and return of mucosal wave in 18 of 24 VFs operated on for the excision of cysts or polyps. When present preoperatively (6 patients), the mucosal wave was preserved. Most patients (28 of 30) rated themselves as clinically improved. The endo...

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 1983

The Laryngoscope, 1987

The use of the carbon dioxide laser as an endoscopic microsurgical instrument has stimulated inte... more The use of the carbon dioxide laser as an endoscopic microsurgical instrument has stimulated interest in treating laryngeal and tracheal stenosis. Dedo and Sooy (1984) reported a significant improvement in the management of posterior commissure, subglottic, and high tracheal stenoses with the use of a microtrapdoor flap. A recent laboratory investigation of this method supported the clinical efficacy of this technique. Six patients are evaluated in this report, three with posterior commissure stenosis and three with subglottic or high tracheal lesions. All six patients had a tracheotomy present or performed at the time of their surgical procedures, and each patient had only one procedure. All six had improved airways after the microtrapdoor flaps. Five have been decannulated and one patient with associated hypopharyngeal stenosis still has a tracheostomy because of mild aspiration, although the airway lumen is moderately improved. It is felt that, as a group, the subglottic and high...

The Annals of otology, rhinology, and laryngology, 1990

The composite nasal septal graft has been used successfully by us to reconstruct patients with hi... more The composite nasal septal graft has been used successfully by us to reconstruct patients with high tracheal and laryngotracheal stenosis. We have treated ten patients and have been able to decannulate seven of these patients. When these ten cases are added to the six original cases presented in an earlier report (1981), certain conclusions can be drawn. The success or failure of these procedures, which is judged by the ability to decannulate the patient, appears to be related to the extent of the initial injury. We discuss the indications for the composite nasal septal graft and the use of additional treatment, including stents, steroid injections, dilatations, and flaps. In conclusion, the addition of these ten cases to the original six cases of composite nasal septal grafts now provides the opportunity to review indications and contraindications for the use of this graft in the management of advanced laryngotracheal stenosis.

Annals of Otology, Rhinology & Laryngology, 1998

Microvascular lesions, also called varices or capillary ectasias, in contrast to vocal fold polyp... more Microvascular lesions, also called varices or capillary ectasias, in contrast to vocal fold polyps with telangiectatic vessels, are relatively small lesions arising from the microcirculation of the vocal fold. Varices are most commonly seen in female professional vocalists and may be secondary to repetitive trauma, hormonal variations, or repeated inflammation. Microvascular lesions may either be asymptomatic or cause frank dysphonia by interrupting the normal vibratory pattern, mass, or closure of the vocal folds. They may also lead to vocal fold hemorrhage, scarring, or polyp formation. Laryngovideostroboscopy is the key in determining the functional significance of vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization. Indications for surgery are recurrent hemorrhage, enlargement of the varix, development of a mass in conjunction with the varix or hemorrhage, and unacceptable dysphonia after maximal medical and speech therapy due to a functionally significant varix.

Cummings Otolaryngology - Head and Neck Surgery, 2010

As part of our computer assisted surgical techniques (CAST) program, we use computers to assist i... more As part of our computer assisted surgical techniques (CAST) program, we use computers to assist in the guidance of surgical lasers. The computer helps to create laser incisions with minimal widths, a reduction of collateral thermal damage, and regulates the rate of tissue ablation. Previous studies have compared laser incisions under manual control to incisions made with the CAST system.

Cancer Treatment and Research, 1987

Laser-Tissue Interaction Vi, Proceedings of, 1995

ABSTRACT Laser-induced thermal-elastic stress waves are of importance both in therapeutic applica... more ABSTRACT Laser-induced thermal-elastic stress waves are of importance both in therapeutic applications and in potential morbidity associated with laser surgical procedures. Recent experiments have shown that drug cytotoxicity can be enhanced with stress waves and that direct cell injury correlates with the stress gradient (stress rate of change). To systematically investigate the biological effects of stress waves, it is essential to vary individually the parameters of the stress wave. The Free Electron Laser (FEL) is the ideal laser for generating controllable stress waves. A unipolar stress wave can be characterized by its rise time, duration, peak pressure, and decay time. For short laser pulses, the rise time and decay time are dependent upon the absorption depth of the tissue and can be varied by changing the wavelength of the FEL. The duration of the stress wave can be changed by selecting a different number of micropulses from the FEL macropulse with Pockels cell. The peak pressure can be altered by varying the laser intensity. Results on water have confirmed that the individual parameters of the stress wave can be varied independently.

The Annals of otology, rhinology, and laryngology, 2007

We developed and validated a disorder-specific health status instrument (Singing Voice Handicap I... more We developed and validated a disorder-specific health status instrument (Singing Voice Handicap Index; SVHI) for use in patients with singing problems. Prospective instrument validation was performed. Of 81 original items, those with poor statistical validity were eliminated, resulting in 36 items. The ability to discriminate dysphonic from normal singers, test-retest reliability, internal consistency, and construct validity were assessed. We included 112 dysphonic and 129 normal singers, professional and nonprofessional, of classical, country, rock, choral, and gospel repertoire. Dysphonic singers had worse SVHI scores than normal singers (p < or = .001, rank sum test). Test-retest reliability was high (Spearman correlation, 0.92; p < or = .001). Internal consistency demonstrated a Cronbach's alpha of .97, and the correlation between the SVHI and self-rated singing voice impairment was .63 (p < or = .001, Spearman correlation). The SVHI is a reliable and valid tool for...

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

Laryngoscope, 1997

A survey was conducted to identify demographics and standards of care for treatment of hypopharyn... more A survey was conducted to identify demographics and standards of care for treatment of hypopharyngeal squamous cell carcinoma in the United States. Data were accrued from voluntary submission of cancer registry and medical chart information from 769 hospitals representing 2939 cases diagnosed from 1980 to 1986 and 1990 to 1992. Clinical findings, diagnostic procedures employed, treatment practices, and outcome are presented. Overall, 6-year disease-specific survival was 33.4%, which segregated to 63.1% (stage I), 67.6% (stage 111, 41.8% (stage 1111, and 22% (stage IV). Survival was best for patients treated with surgery only (60.4%), similar with combined surgery and irradiation (48%), and worse with irradiation only (26.8%). This analysis provides a standard to which current treatment practice and future clinical trials may be compared.

Public reporting burden for this collection of information is estimated to average 1 hour per res... more Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project (0704-0188), Washington, DC 20503.

Survey of Anesthesiology, 1985

Studies were undertaken by the Departments of Otolaryngology-Head and Neck Surgery and Anesthesio... more Studies were undertaken by the Departments of Otolaryngology-Head and Neck Surgery and Anesthesiology at Northwestern University Medical School and the Medical College of Wisconsin (Milwaukee) to compare the potential for tissue injury to the trachea and lungs of canines. Polyvinylchloride (PVC), Rusch red rubber, and silicone tubes were tested. The effects of an intraluminal tube fire on the larynx and trachea were documented with laryngeal and bronchoscopic photographs taken immediately postburn and at the time of sacrifice six hours later. The most severe burns were associated with the PVC tube. Silica ash was seen in the airway after the silicone tube fires and raises the possibility of future problems with silicosis. Histological examination of the trachea showed acute injury in all of the animals; specimens from the dogs with the PVC tube fires demonstrated the most severe cellular damage.

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1992

The newer generation micromanipulators for the carbon d ioxide laser were introduced in 1987. The... more The newer generation micromanipulators for the carbon d ioxide laser were introduced in 1987. These newer generation micromanipulators are capable of providing laser spot sizes of 300 urn or less at a focal length of 400 mm. In addition to providing a smaller spot size than prior generation micromanipulators, these newer generation instruments also eliminate the parallax aiming error that is present when the mirror is mounted offset from the optical path from the microscope. Because of these two technological advances, COzlaser use has expanded into the pediatric field. Smaller spot sizes have allowed for greater precision for ablation and have allowed application in areas of very limited surgical exposure. Applications include microtrapdoor flap for subglottic stenosis scar treatment, and adjunctive ablation of granulation and scar in choanal atresia repair.

The Laryngoscope, Jan 3, 2015

A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplaki... more A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplakia therapeutically decreased dysplasia grade. The current investigation aimed to 1) analyze the pathological evolution and natural history of these lesions and 2) re-examine the role of serial excisions in dysplasia grade regression in long-term follow-up. Retrospective case series. Patients treated for vocal fold dysplasia (1994-2013) with serial full-thickness microflap-type excisions were identified and followed longitudinally. Excluded were those with one excision, invasive cancer at initial excision, or history of laryngeal cancer or radiation. Data from surgical procedures, associated pathology, and patient characteristics were recorded. Weighted repeated measures ordinal logistic regression measured associations with pathology findings. Of 55 patients (median age = 65 years, interquartile range = 54-73 years, 89% male, 63% ever smokers, 27% alcohol users), 31 met inclusion criteria...

Operative Techniques in Otolaryngology-Head and Neck Surgery, 1993

The Annals of otology, rhinology, and laryngology, 1995

Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina pro... more Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina propria must permit the preservation and/or restoration of VF vibratory characteristics. The endoscopic VF microflap is designed to do such. A retrospective study was undertaken to evaluate the efficacy of this procedure. Forty microflaps (7 bilateral, 1 revision) were performed on 32 patients. Charts and surgical pathology findings were reviewed. Preoperative and 3-month postoperative video recorded voice samples and stroboscopic examination results were compared. Findings on perceptual voice analysis did not significantly change. Stroboscopic examinations revealed improved postoperative VF closure in 27 of 29 patients with impaired preoperative closure and return of mucosal wave in 18 of 24 VFs operated on for the excision of cysts or polyps. When present preoperatively (6 patients), the mucosal wave was preserved. Most patients (28 of 30) rated themselves as clinically improved. The endo...

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 1983

The Laryngoscope, 1987

The use of the carbon dioxide laser as an endoscopic microsurgical instrument has stimulated inte... more The use of the carbon dioxide laser as an endoscopic microsurgical instrument has stimulated interest in treating laryngeal and tracheal stenosis. Dedo and Sooy (1984) reported a significant improvement in the management of posterior commissure, subglottic, and high tracheal stenoses with the use of a microtrapdoor flap. A recent laboratory investigation of this method supported the clinical efficacy of this technique. Six patients are evaluated in this report, three with posterior commissure stenosis and three with subglottic or high tracheal lesions. All six patients had a tracheotomy present or performed at the time of their surgical procedures, and each patient had only one procedure. All six had improved airways after the microtrapdoor flaps. Five have been decannulated and one patient with associated hypopharyngeal stenosis still has a tracheostomy because of mild aspiration, although the airway lumen is moderately improved. It is felt that, as a group, the subglottic and high...

The Annals of otology, rhinology, and laryngology, 1990

The composite nasal septal graft has been used successfully by us to reconstruct patients with hi... more The composite nasal septal graft has been used successfully by us to reconstruct patients with high tracheal and laryngotracheal stenosis. We have treated ten patients and have been able to decannulate seven of these patients. When these ten cases are added to the six original cases presented in an earlier report (1981), certain conclusions can be drawn. The success or failure of these procedures, which is judged by the ability to decannulate the patient, appears to be related to the extent of the initial injury. We discuss the indications for the composite nasal septal graft and the use of additional treatment, including stents, steroid injections, dilatations, and flaps. In conclusion, the addition of these ten cases to the original six cases of composite nasal septal grafts now provides the opportunity to review indications and contraindications for the use of this graft in the management of advanced laryngotracheal stenosis.

Annals of Otology, Rhinology & Laryngology, 1998

Microvascular lesions, also called varices or capillary ectasias, in contrast to vocal fold polyp... more Microvascular lesions, also called varices or capillary ectasias, in contrast to vocal fold polyps with telangiectatic vessels, are relatively small lesions arising from the microcirculation of the vocal fold. Varices are most commonly seen in female professional vocalists and may be secondary to repetitive trauma, hormonal variations, or repeated inflammation. Microvascular lesions may either be asymptomatic or cause frank dysphonia by interrupting the normal vibratory pattern, mass, or closure of the vocal folds. They may also lead to vocal fold hemorrhage, scarring, or polyp formation. Laryngovideostroboscopy is the key in determining the functional significance of vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization. Indications for surgery are recurrent hemorrhage, enlargement of the varix, development of a mass in conjunction with the varix or hemorrhage, and unacceptable dysphonia after maximal medical and speech therapy due to a functionally significant varix.

Cummings Otolaryngology - Head and Neck Surgery, 2010

As part of our computer assisted surgical techniques (CAST) program, we use computers to assist i... more As part of our computer assisted surgical techniques (CAST) program, we use computers to assist in the guidance of surgical lasers. The computer helps to create laser incisions with minimal widths, a reduction of collateral thermal damage, and regulates the rate of tissue ablation. Previous studies have compared laser incisions under manual control to incisions made with the CAST system.

Cancer Treatment and Research, 1987

Laser-Tissue Interaction Vi, Proceedings of, 1995

ABSTRACT Laser-induced thermal-elastic stress waves are of importance both in therapeutic applica... more ABSTRACT Laser-induced thermal-elastic stress waves are of importance both in therapeutic applications and in potential morbidity associated with laser surgical procedures. Recent experiments have shown that drug cytotoxicity can be enhanced with stress waves and that direct cell injury correlates with the stress gradient (stress rate of change). To systematically investigate the biological effects of stress waves, it is essential to vary individually the parameters of the stress wave. The Free Electron Laser (FEL) is the ideal laser for generating controllable stress waves. A unipolar stress wave can be characterized by its rise time, duration, peak pressure, and decay time. For short laser pulses, the rise time and decay time are dependent upon the absorption depth of the tissue and can be varied by changing the wavelength of the FEL. The duration of the stress wave can be changed by selecting a different number of micropulses from the FEL macropulse with Pockels cell. The peak pressure can be altered by varying the laser intensity. Results on water have confirmed that the individual parameters of the stress wave can be varied independently.