Moataz D Abouammo | The Ohio State University (original) (raw)

Papers by Moataz D Abouammo

Operative neurosurgery, Mar 20, 2024

Background and objectives: Expanded endonasal approaches (EEAs) have proven safe and effective in... more Background and objectives: Expanded endonasal approaches (EEAs) have proven safe and effective in treating select petrous apex (PA) pathologies. Angled endoscopes and instruments have expanded indications for such approaches; however, the complex neurovascular anatomy surrounding the petrous region remains a significant challenge. This study evaluates the feasibility, anatomic aspects, and limitations of a contralateral nasofrontal trephination (CNT) route as a complementary corridor improving access to the PA.

Methods: Expanded endonasal and CNT approaches to the PA were carried out bilaterally in 15 cadaveric heads with endovascular latex injections. The distance to the PA, angle between instruments through the 2 approach portals, and surgical freedom were measured and compared.

Results: Three-dimensional DICOM-based modeling and visualization indicate that the CNT route reduces the distance to the target located within the contralateral PA by an average of 3.33 cm (19%) and affords a significant increase in the angle between instruments (15.60°; 54%). Furthermore, the vertical vector of approach is improved by 28.97° yielding a caudal reach advantage of 2 cm. The area of surgical freedom afforded by 3 different approaches (endonasal, endonasal with an endoscope in CNT portal, and endonasal with an instrument in CNT portal) was compared at 4 points: the dural exit point of the 6th cranial nerve, jugular foramen, foramen lacerum, and petroclival fissure. The mean area of surgical freedom provided by both approaches incorporating the CNT corridor was superior to EEA alone at each of the surgical targets ( P = <.001).

Conclusion: The addition of a CNT portal provides an additional avenue to expand on the classical EEA to the PA. This study provides insight into the anatomic nuances and potential clinical benefits of a dual-port approach to the PA.

Tanta Medical Journal, Oct 1, 2023

Background: The close proximity of both thyroid and parathyroid glands to the larynx puts them at... more Background: The close proximity of both thyroid and parathyroid glands to the larynx puts them at high risk to develop hypofunction from the treatment of cancer larynx.
Aim: Thyroid and parathyroid function evaluation after treatment modalities of cancer larynx.
Patients and Methods: Thyroid and parathyroid function was evaluated in 60 patients treated from laryngeal carcinoma. Patients were classified into 3 groups based on treatment type. Group 1 included patients with primary radiotherapy while group 2 included patients with total laryngectomy and group 3 involved patients with combined total laryngectomy and postoperative radiotherapy. Laboratory assessment of thyroid function included TSH, free T4, while parathyroid function included corrected serum calcium and parathormone levels. The association of gland hypofunction was studied against tumor and treatment characteristics.
Results: Among the 60 patients; group 1 included 27 patients, group 2 included 21 patients 15 and group 3 included 12 patients. 25 patients (41.7%) showed high TSH level and low FT4 level indicating clinical hypothyroidism while 12 patients (20%) showed high TSH level with normal FT4 level indicating subclinical hypothyroidism. 23 patients (38.3%) showed normal levels of both TSH and FT4 being euthyroid. Concerning parathyroid function; 19 (31.7%) showed hypoparathyroidism diagnosed by low corrected serum calcium level and confirmed by low PTH level.

Conclusion: The study detects the occurrence of hypothyroidism with or without hypoparathyroidism after treatment modalities of cancer larynx emphasizing the need of high clinical suspicion and routine evaluation for early detection of any post treatment thyroid or parathyroid gland hypofunction.

Key Words: Cancer larynx - Laryngectomy – Thyroid – Parathyroid.

Acta neurochirurgica, May 7, 2024

The Laryngoscope, Apr 23, 2024

Journal of neurological surgery. Part B, Skull base, Feb 1, 2024

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Head & Neck, Oct 11, 2023

Operative Neurosurgery, Jan 7, 2024

Neurosurgical focus, Apr 1, 2024

OBJECTIVE Minimally invasive endoscopic endonasal multiport approaches create additional visualiz... more OBJECTIVE Minimally invasive endoscopic endonasal multiport approaches create additional visualization angles to treat skull base pathologies. The sublabial contralateral transmaxillary (CTM) approach and superior eyelid lateral transorbital approach, frequently used nowadays, have been referred to as the "third port" when used alongside the endoscopic endonasal approach (EEA). The endoscopic precaruncular contralateral medial transorbital (cMTO) corridor, on the other hand, is an underrecognized but unique port that has been used to repair CSF rhinorrhea originating from the lateral sphenoid sinus recess. However, no anatomical feasibility studies or clinical experience exists to assess its benefits and demonstrate its potential role in multiport endoscopic access to the other contralateral skull base areas. In this study, the authors explored the application and potential utility of multiport EEA combined with the endoscopic cMTO approach (EEA/cMTO) to three target areas of the contralateral skull base: lateral recess of sphenoid sinus (LRSS), petrous apex (PA) and petroclival region, and retrocarotid clinoidocavernous space (CCS). METHODS Ten cadaveric specimens (20 sides) were dissected bilaterally under stereotactic navigation guidance to access contralateral LRSS via EEA/cMTO. The PA and petroclival region and retrocarotid CCS were exposed via EEA alone, EEA/cMTO, and EEA combined with the sublabial CTM approach (EEA/CTM). Qualitative and quantitative assessments, including working distance and visualization angle to the PA, were recorded. Clinical application of EEA/ cMTO is demonstrated in a lateral sphenoid sinus CSF leak repair. RESULTS During the qualitative assessment, multiport EEA/cMTO provides superior visualization from a high vantage point and better instrument maneuverability than multiport EEA/CTM for the PA and retrocarotid CCS, while maintaining a similar lateral trajectory. The cMTO approach has significantly shorter working distances to all three target areas compared with the CTM approach and EEA. The mean distances to the LRSS, PA, and retrocarotid CCS were 50.69 ± 4.28 mm (p < 0.05), 67.11 ± 5.05 mm (p < 0.001), and 50.32 ± 3.6 mm (p < 0.001), respectively. The mean visualization angles to the PA obtained by multiport EEA/cMTO and EEA/CTM were 28.4° ± 3.27° and 24.42° ± 5.02° (p < 0.005), respectively. CONCLUSIONS Multiport EEA/cMTO to the contralateral LRSS offers the advantage of preserving the pterygopalatine fossa contents and the vidian nerve, which are frequently sacrificed during a transpterygoid approach. This approach

Journal of advances in medicine and medical research, Apr 14, 2023

International Journal of TROPICAL DISEASE & Health

Background: Esophagogastroduodenoscopy (EGD) is the gold standard for detecting oesophageal varic... more Background: Esophagogastroduodenoscopy (EGD) is the gold standard for detecting oesophageal varices (OVs) in cirrhotic patients. However, due to the possible limitations of EGD, there has been much interest in the use of non-invasive techniques for this purpose. This study aimed to evaluate the use of platelet count/ spleen diameter ratio (PC/SD) in the prediction of the presence and grading of OVs in cirrhotic patients. Methods: One hundred cirrhotic patients were included in this cross-sectional study and subjected to EGD after informed consent. Either absence or the grade of OVs if existent was correlated with values of the PC/SD ratio. Univariate and multivariate analyses of data and areas under the receiver operating characteristic curve (AUC) were used. Results: The PC/SD ratio was a good indicator in predicting the development of OVs (AUC of 0.897) with cut-off values of (987.28). Also, it correlated well with grades of oesophageal varices, a significant stepwise progressive ...

Tanta Medical Journal, 2020

Background Pulmonary embolism (PE) is the blockage of the main pulmonary artery or one of its bra... more Background Pulmonary embolism (PE) is the blockage of the main pulmonary artery or one of its branches by a substance that has traveled from elsewhere in the body through the bloodstream. PE is an acute and potentially fatal condition. PE is the most common cause of preventable hospital death. Thrombophilia (also known as hypercoagulability) can be defined as a predisposition to form clots inappropriately. Since the turn of the last century, there has been extensive research focusing on both the genetic and acquired causes of thrombophilia, with particular focus on clotting events in the venous circulation. Aim The aim of the work was to study the role of thrombophilia in PE. Patients and methods This study was carried out in the Chest Department at Tanta University Hospitals on 40 consecutive cases of PE, randomly recruited from Tanta University Hospitals’ outpatient clinics and emergency rooms, starting from February 2017 to February 2018. In this study, there was specific focus o...

Leukemia Research, 2021

Determination of Bax/Bcl-2 ratio may be a good predictive tool to recognize chronic lymphocytic l... more Determination of Bax/Bcl-2 ratio may be a good predictive tool to recognize chronic lymphocytic leukemia (CLL) patients' outcome and prognosis to decide the time and type of therapy. This prospective study was carried out on 100 patients with newly diagnosed CLL. Bax and Bcl-2 expression in peripheral blood were measured by flow-cytometry. The association of Bax/Bcl-2 ratio with CLL laboratory markers, Rai stage, overall survival (OS) and progression-free survival (PFS) at 18 months was investigated. The sensitivity and specificity of Bax/Bcl-2 in predicting survival was evaluated. The best cut-off value of Bax/Bcl-2 ratio to predict the survival, detected by receiver operating characteristic (ROC) curve, was 1.2 with 80 % sensitivity and 60.86 % specificity. A ratio of ≤1.20 was detected in 78 % of patients and was associated with worse prognosis. A lower Bax/Bcl-2 ratio was associated with higher modified Rai stage at time of diagnosis and a significantly shorter both OS (64.1 % versus 90.9 %, p < 0.026) and PFS (66.7 % versus 90.9 %, p < 0.031) at 18 months. In multivariate analysis, bax/bcl-2 ≤ 1.2 was an independent prognostic factor for overall survival, (p = 0.025). We concluded that lower Bax /Bcl-2 ratios were associated with worse prognosis as evidenced by lower OS and PFS in CLL patients. It was also associated with markers of high tumor burden and unfavorable prognostic markers. Recognition of patients with low Bax /Bcl-2 ratio would make them good candidates for the novel Bcl-2 inhibitory targeted chemotherapy to avoid resistance to the traditional therapy.