Edmund Pribitkin | Thomas Jefferson University (original) (raw)

Papers by Edmund Pribitkin

Facial Plastic Surgery, 2020

The ultrasonic bone aspirator (UBA) allows for precision and provides ease of use in multiple ste... more The ultrasonic bone aspirator (UBA) allows for precision and provides ease of use in multiple steps of cosmetic and functional rhinoplasties. Its use has previously been described; however, since the publication of many studies the UBA has been improved and its applications for rhinoplasty have been modified and expanded. Both bony and cartilaginous modifications to the nose can be aided with the use of the UBA. From our experience, patient results have subjectively been found to be more acceptable, if not better, than with the use of other rhinoplasty instruments.

Background: Numerous techniques have been described for nasal septal perforation repair, with var... more Background: Numerous techniques have been described for nasal septal perforation repair, with various degrees of success in achieving closure. Evidence supports the use of bilateral mucoperichondrial advancement flaps with interpositional grafting for greatest success. Many surgeons use autografts such as fascia, cartilage, bone, and pericranium, however, extracellular matrices have also become popular. Objective: We analyze factors determining the success of nasal septal perforations repaired using using an acellular, freeze-dried interpositional xenograft derived from Porcine Small Intestinal Submucosa (PSIS). Methods: Patients with septal perforation repaired by the senior author from 1998 to 2006 were examined in a retrospective chart review with regard to perforation size, etiology, preand postoperative symptoms, follow-up, outcomes and complications. Results: Forty-seven PSIS repairs were performed on 46 patients. Two procedures were planned staged procedures. Of the total 47 procedures, 41 (87.2%) continued to be closed at the site of repair during the follow up period. Follow up ranged from 6 months to 4.9 years with a mean of 18.3 months. Two patients (4.3%) were found to have perforations at the site of closure in the immediate post-operative period. One patient (2.1%) perforated at the site of closure after the immediate post-operative period. Subjective symptom scores demonstrated improvement in crusting, epistaxis and obstruction postoperatively. Larger perforations correlated with poorer outcomes. Conclusions: The authors conclude that closure of nasal septal perforation with an interpositional xenograft derived from PSIS compares favorably to published results for autografts with advantages including absence of donor site morbidity, easy graft modification and manipulation, and shorter operative time.

The Internet Journal of Otorhinolaryngology, 2003

The diagnosis of carotidynia, an idiopathic pain syndrome of the neck, remains controversial in p... more The diagnosis of carotidynia, an idiopathic pain syndrome of the neck, remains controversial in part due to a paucity of associated radiographic findings. However, MRI/MRA provides diagnostic information in the evaluation of presumed carotidynia. Moreover, MRI/MRA findings localize the inflammatory process associated with carotidynia to the carotid sheath. We present a single case report in conjunction with a literature review and review the utility of magnetic resonance imaging [MRI] and magnetic resonance angiography [MRA] in confirming the diagnosis of carotidynia. We conclude that MRI/MRA should therefore be used as the primary radiologic modality by which to assess patients with presumed carotidynia.

PURPOSE Tc-99m sestamibi (MIBI) scintigraphy is commonly utilized for the preoperative location o... more PURPOSE Tc-99m sestamibi (MIBI) scintigraphy is commonly utilized for the preoperative location of parathyroid adenomas. A focal area of tracer retention that persists on delayed images is fairly specific for a parathyroid adenoma. Occassionally, there are 2 foci of MIBI retention on delayed imaging, which theorectically suggests a double parathyroid adenoma. Our aim was to determine just how often this finding was shown to represent a double adenoma. METHOD AND MATERIALS Over a 4-year interval, all parathyroid scans with the finding of 2 areas of MIBI concentration in initial images of the neck, that retained the tracer on 3-hour delayed images were collected and corresponding histopathological results were reviewed. RESULTS A total of 16 patients demonstrated the above finding. Of these, 14 underwent neck exploration; 12 were diagnosed as having asymmetric parathyroid gland hyperplasia, while only 2 were diagnosed with double parathyroid adenoma. CONCLUSION Of the group of 14 pati...

The Annals of otology, rhinology, and laryngology, 2010

This study was performed to determine whether teens have different rates of posttonsillectomy hem... more This study was performed to determine whether teens have different rates of posttonsillectomy hemorrhage, admission for dehydration, or recurrent tonsillitis compared to adults. Specifically, these parameters were compared within two groups: patients who underwent powered intracapsular tonsillectomy (PIT) and those who underwent monopolar electrocautery tonsillectomy (MET). In a retrospective review of 579 patients at least 12 years of age from January 2000 to July 2006 in a tertiary referral center, outcome measures of reoperation for hemorrhage, readmission or emergency room visit for dehydration, and postoperative tonsillitis were compared for 200 patients 12 to 19 years of age and 379 patients more than 19 years of age. These outcome measures in teens were compared to those in adults who had tonsillectomy by the same technique (101 teens who underwent PIT compared to 117 adults who underwent PIT, and 99 teens who underwent MET compared to 262 adults who underwent MET). Outcome m...

Surgical Neurology International, 2012

Background: Traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesi... more Background: Traumatic intracranial pseudoaneurysms remain one of the most difficult vascular lesions to treat. In the case of traumatic pseudoaneurysms that may not be treated with parent vessel sacrifice, some flow diversion strategy such as stent-assistance or use of a flow diversion device is usually necessary. Case Description: In this study we describe endovascular parent vessel wall-remodeling/endoluminal reconstruction and traumatic pseudoaneurysm thrombosis through the use of the Pipeline stent and review recent reports concerning indications, safety, and efficacy for alternative pathology. Conclusion: Although currently not routinely employed in the treatment of traumatic pseudoaneurysms, the Pipeline stent may represent a safe and effective treatment alternative achieving complete endoluminal reconstruction of the damaged vessel wall.

International Forum of Allergy & Rhinology, 2014

Objective-Besides sensorineural factors, conductive impediments likely contribute to olfactory lo... more Objective-Besides sensorineural factors, conductive impediments likely contribute to olfactory losses in chronic rhinosinusitis (CRS) patients, yet no conclusive evidence exists. We aimed to examine possible conductive factors using computational fluid dynamics (CFD) models. Methods-29 CRS patients were assessed via odorant detection thresholds (ODTs), rhinomanometry (nasal resistance: NR), acoustic rhinometry (minimum-cross-sectional area: MCA) and CT staging. CFD simulations of nasal airflow and odorant absorption to olfactory

The Laryngoscope, 2011

Objectives/Hypothesis-This study evaluated two versions of a test for olfactory function to deter... more Objectives/Hypothesis-This study evaluated two versions of a test for olfactory function to determine suitability for use in a pediatric population. Study Design-Cross-sectional cohort study. Method-In phase 1, 369 children (ages 3-17 years) and 277 adults (parents) were tested. Children began with identification and familiarity judgments to pictures representing target odors and distractors. Odors were administered via a six-item scratch and sniff test. Each answer sheet contained the correct odor source and three distractors. In phase 2, 50 children (ages 3-4 years) and 43 adults were given a revised version with eight odors judged more representative of the source and familiar to children. Results-Both completion time and identification accuracy in phase 1 improved with age. Accuracy of children 5 years old and above equaled adults for two of the three best odors. In phase 2, adults' accuracy significantly improved relative to phase 1 (92% vs. 68%), and exceeded that of 4 year olds for four of eight odors and 3 year olds for seven of eight odors. Conclusions-Children as young as 3 years of age can perform olfactory testing, but take longer than do older children and adults (7.44 vs. 5.66 vs. 3.71 minutes). Identification accuracy also increases as a function of age. The current six-item National Institutes of Health Toolbox Odor Identification Test is a brief, easily conducted test for evaluating olfactory ability. Collection of normative data for children of all ages and adults is needed to determine the clinical utility of the test and its interpretations for pathological conditions.

The Laryngoscope, 2005

To determine the feasibility of recurrent laryngeal nerve monitoring and stimulation during endos... more To determine the feasibility of recurrent laryngeal nerve monitoring and stimulation during endoscopic neck surgery in an animal model. Prospective, nonrandomized experimental investigation in a porcine model. Bilateral recurrent laryngeal nerve monitoring and stimulation was accomplished during endoscopic neck surgery in five domestic pigs. Each pig was intubated with an electromyography endotracheal tube. Recurrent laryngeal nerve function was monitored throughout the endoscopic neck surgery with a nerve integrity monitor system. An endoscopic surgical pocket was created in the neck using blunt dissection followed by low-pressure carbon dioxide insufflation. Under direct endoscopic visualization, the trachea, thyroid gland, and associated vasculature were identified. The recurrent laryngeal nerve was identified on each side of the animal and was successfully stimulated with a monopolar stimulator probe. Ten of ten recurrent laryngeal nerves were successfully monitored and stimulated. No significant complications were encountered during the procedures. Recurrent laryngeal nerve monitoring and stimulation may be successfully accomplished during endoscopic neck surgery.

Otolaryngology - Head and Neck Surgery, 2008

Otolaryngology–Head and Neck Surgery, 2004

Few studies have evaluated the degree of xerostomia in long-term cancer survivors or its impact o... more Few studies have evaluated the degree of xerostomia in long-term cancer survivors or its impact on quality of life (QOL). The purpose of this study was to objectively measure the degree of xerostomia and to determine the effect of xerostomia POSTERS Otolaryngology-Head and Neck Surgery Volume 131 Number 2 Research Posters P183

The Internet Journal of Endocrinology, 2005

Objectives/Hypothesis: To review the clinical and pathological picture of hyalinizing trabecular ... more Objectives/Hypothesis: To review the clinical and pathological picture of hyalinizing trabecular neoplasm of the thyroid [HTN] and compare HTN with papillary thyroid carcinoma [PTC] in order to discuss the appropriate management of this uncommon but potentially confusing neoplasm. Study Design: A case review of a patient with HTN treated at our institution. Methods: Case review and MEDLINE literature search. Results: Although recognized as a tumor of uncertain malignant potential in the pathology literature, HTN has been rarely reported in otolaryngology journals, and its management remains controversial. HTN and PTC share similar histopathological characteristics and have been described as coexistent lesions in the same thyroid. HTN's have also exhibited proto-oncogenes associated with PTC. Moreover, recent reports have described cases of HTN exhibiting vascular or capsular invasion and metastases. Conclusions: HTN should still be considered a neoplasm of uncertain malignant potential. Criteria for the treatment of HTN have yet to be determined, and many investigators are concerned about the prudence of making broad recommendations on the basis of a few studied cases. Nonetheless, when discussing surgical treatment options and recommendations for postoperative monitoring and radionuclide ablation in patients diagnosed with HTN, physicians may be guided by the criteria for the treatment of PTC at their respective institutions.

Archives of Otolaryngology - Head and Neck Surgery, 2008

American Journal of Psychiatry, 2005

The authors examined the feasibility of using olfactory receptor neurons from living patients to ... more The authors examined the feasibility of using olfactory receptor neurons from living patients to test whether calcium signaling is altered in a neuronal cell population in bipolar disorder. Method: Ratiometric fluorescence photomicroscopy was used to assess basal and stimulus-induced changes in intracellular calcium levels in biopsy-derived olfactory receptor neurons from seven euthymic patients with bipolar disorder who were medication-free, 10 euthymic patients with bipolar disorder who were treated with mood stabilizers, and 17 age-and sexmatched comparison subjects without bipolar disorder. Results: Olfactory receptor neurons from the seven medication-free patients responded to stimuli predominantly with decreases in intracellular calcium, unlike those from the seven matched healthy subjects. Olfactory receptor neurons from patients treated with mood stabilizers were less likely to respond to stimulation than olfactory receptor neurons from medication-free patients. Conclusions: This study demonstrates the feasibility of using olfactory receptor neurons to examine alterations in intracellular signaling in neuronal cells from living patients. Our results, although based on a small number of subjects, suggest that altered intracellular calcium signaling in olfactory receptor neurons may be a trait of bipolar disorder.

Acta Neurochirurgica, 2010

Superficial siderosis of the central nervous system is a rare disorder with hemosiderin depositio... more Superficial siderosis of the central nervous system is a rare disorder with hemosiderin deposition in the spinal and cranial leptomeninges and subpial layer, mostly from repetitive subarachnoid hemorrhage. Progressive sensorineural deafness, cerebellar ataxia, and pyramidal signs comprise the typical clinical presentation. We describe a 47-year-old patient, who showed initial 2-year improvement after successful occlusion of an intradural bleeding source at T4. Secondary progression of symptoms without further bleedings was noted thereafter, with a clinical picture of amyotrophic lateral sclerosis. This case illustrates that the disease may progress secondarily even without re-bleedings, and that secondary progression might be due to a similar pathomechanism as in amyotrophic lateral sclerosis.

Journal of Otology & Rhinology, 2012

Part of the Otolaryngology Commons This Article is brought to you for free and open access by the... more Part of the Otolaryngology Commons This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in

Facial Plastic Surgery, 2010

Clinical Cancer Research, 2007

Voltage-gated Kv potassium channels, like ether a go-go (EAG) channels, have been recognized for ... more Voltage-gated Kv potassium channels, like ether a go-go (EAG) channels, have been recognized for their oncogenic potential in breast cancer and other malignant tumors. Experimental Design: We examined the molecular and functional expression of Kv channels in human colonic cancers and colon of mice treated with the chemical carcinogens dimethylhydrazine and N-methyl-N-nitrosourea. The data were compared with results from control mice and animals with chemically induced DSS colitis. Results: Electrogenic salt transport by amiloride-sensitive Na + channels and cyclic AMPâ ctivated cystic fibrosis transmembrane conductance regulator Cl À channels were attenuated during tumor development and colitis, whereas Ca 2+-dependent transport remained unchanged. Kv channels, in particular Eag-1, were enhanced during carcinogenesis. Multiplex reverse transcription-PCR showed increased mRNA expression for Kv1.3, Kv1.5, Kv3.1, and members of the Eag channel family, after dimethylhydrazine and N-methyl-N-nitrosourea treatment. Eag-1protein was detected in the malignant mouse colon and human colonic cancers. Genomic amplification of Eag-1 was found in 3.4% of all human colorectal adenocarcinoma and was an independent marker of adverse prognosis. Conclusions: The study predicts an oncogenic role of Kv and Eag channels for the development of colonic cancer.These channels may represent an important target for a novel pharmacotherapy of colonic cancer.

Otolaryngology–Head and Neck Surgery

Educational Objectives: 1) Identify the major causes of mortality and permanent disability relate... more Educational Objectives: 1) Identify the major causes of mortality and permanent disability related to tonsillectomy and summarize relevant risk factors for these catastrophic events. 2) Discuss the potential contributions of apnea, ultra-rapid codeine metabolism phenotype, and narcotic overdose to the pathogenesis of post-tonsillectomy death and disability. 3) Describe appropriate, evidence-based strategies for managing pain after tonsillectomy and summarize the current state of knowledge regarding criteria for admission and monitoring after tonsillectomy.

Thyroid : official journal of the American Thyroid Association, 2018

Molecular markers are increasingly used as diagnostic tools in the management of thyroid nodules.... more Molecular markers are increasingly used as diagnostic tools in the management of thyroid nodules. There is a paucity of studies evaluating the prevalence of molecular markers in benign lesions. A 68-year-old woman with hypothyroidism presented with a right thyroid nodule, which was atypia of undetermined significance on cytology. The fine-needle aspirate of the nodule was examined with next-generation sequencing and found to harbor a C228T mutation in the TERT gene, a Q61R mutation in the HRAS gene, and an A113_splice mutation in the EIF1AX gene. Right thyroid lobectomy was performed, with final pathology showing follicular adenoma. All three mutations detected in the original fine-needle aspirate specimen were detected in the final surgical specimen as well. A rare case of TERT, HRAS, and EIF1AX mutations is reported in a patient with follicular adenoma. TERT promoter mutations may be an early genetic event in the molecular pathogenesis of follicular thyroid carcinoma.