Author Interviews, ENT, Pediatrics, University of Pittsburgh / 13.05.2021

MedicalResearch.com Interview with: Alejandro Hoberman, M.D. Vice Chair of Clinical Research, Division Director, General Academic Pediatrics, and Professor of Pediatrics and Clinical and Translational Science Jack L. Paradise, MD Endowed Professor of Pediatric Research, UPMC Children's Hospital of PittsburghPresident, UPMC Children's Community Pediatrics MedicalResearch.com: What is the background for this study? Response: Acute otitis media (AOM) is the most frequently diagnosed illness in children in the United States for which antibiotics are prescribed. Recurrent AOM is the principal indication for tympanostomy-tube placement, the most frequently performed operation in children after the newborn period. Supporting the performance of tympanostomy-tube placement for recurrent acute otitis media has been the commonplace observation, after surgery, of acute otitis media–free periods of varying duration. Counterbalancing this view have been the cost of tympanostomy-tube placement; risks and possible late sequelae of anesthesia in young children; the possible occurrence of refractory tube otorrhea, tube blockage, premature extrusion, or dislocation of the tube into the middle-ear cavity; various structural tympanic membrane sequelae; and the possible development of mild conductive hearing loss. Tempering support for surgery is the progressive reduction in the incidence of acute otitis media that usually accompanies a child’s increasing age. Previous trials of tympanostomy-tube placement for recurrent acute otitis media, all conducted before the introduction of pneumococcal conjugate vaccine, have given mixed results and were limited, variously, by small sample size, uncertain validity of diagnoses of acute otitis media determining trial eligibility, short periods of follow-up, and substantial attrition of participants. Official recommendations regarding tympanostomy-tube placement for children with recurrent acute otitis media differ — an otolaryngologic guideline recommends the procedure for children with recurrent acute otitis media, provided that middle-ear effusion is present in at least one ear; a contemporaneous pediatric guideline discusses tympanostomy-tube placement as an “option [that] clinicians may offer.” Given these uncertainties, we undertook the present trial involving children 6 to 35 months of age who had a history of recurrent acute otitis media to determine whether tympanostomy-tube placement, as compared with medical management (comprising episodic antimicrobial treatment, with the option of tympanostomy-tube placement in the event of treatment failure), would result in a greater reduction in the children’s rate of recurrence of acute otitis media during the ensuing 2-year period. (more…)
Accidents & Violence, Author Interviews, ENT, JAMA / 09.12.2019

MedicalResearch.com Interview with: Roman Povolotskiy MD Candidate '20 Rutgers University New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: The idea for the study came from seeing a few patients with stories of their injuries related to cellphones. Aside from the now ubiquitous texting while driving, we also had patients who were dropping cellphones on their faces while texting in bed. We wanted to see how many head and neck injuries are related to these devices that we can’t seem to take out hands or eyes off of. The main findings were that the incidence of cell phone related injuries has seen a dramatic rise in the recent decade, starting around the time that smart phones really started to take off. We also found that this problem is most prevalent in the adolescent and young adult age groups. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties. (more…)
Accidents & Violence, Author Interviews, ENT, Pediatrics / 06.06.2019

MedicalResearch.com Interview with: Dr. Garth Essig, MD Otolaryngologist The Ohio State University Wexner Medical Center.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dog bites are a significant yet modifiable public health concern, but the true magnitude is difficult to estimate with such wide ranges in reporting, severity of injury and varieties of breeds that bite.  We reviewed bites from reports in the literature and from two regionally distinct medical centers. We concluded that bite frequency and severity could be attributed to certain breeds in this sample, if the breed is known. Our study also acknowledged the significant risk of biting with the mixed breed population, which creates a dilemma with identification. (more…)
Author Interviews, ENT / 03.06.2019

MedicalResearch.com Interview with: Edward McCoul, MD, MPH, FACS Associate Professor Director, Rhinology and Sinus Surgery Department of Otorhinolaryngology Ochsner Clinic New Orleans, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although the potential for doctors and patients to misunderstand each other has been noted in other areas of medicine, the meaning of the word "congestion" had not previously been the subject of study.  This paper calls attention to the relevance of potential communication gap in otolaryngology.  This is particularly important since congestion is a major diagnostic criteria of sinusitis, which ranks nationwide in the top 5 reasons for clinical encounters year after year.  If a communication gap is evident around this particular term, which is integral to establishing a diagnosis of sinusitis, then the likelihood increases that patients who present with "sinusitis" will be incorrectly diagnosed. The process of congestion refers to the microscopic accumulation of blood and/or fluid within cells or the spaces between cells in a particular tissue or body part.  When this occurs in the nose, the result is swelling inside the nose, which narrows the space for air to flow.  A patient would perceive this as blockage or obstruction of airflow.  This can be treated with anti-inflammatory medication that reduces swelling.  Medications that clear up mucus generally are not great at reducing swelling.  Many over-the-counter products are available that combine both types of medications, but using those products runs the risk of overmedication, which can have adverse consequences. (more…)
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 06.11.2018

MedicalResearch.com Interview with: Dr. Evan M. Graboyes MD Otolaryngologist: Head and Neck Surgeon Medical University of South Carolina MedicalResearch.com: What is the background for this study? Response: Unfortunately, there is no screening test for head and neck cancer like there is for colorectal, prostate, breast, lung, or cervical cancers. As a result, two-thirds of patients with head and neck cancer (HNC) present with loco-regionally advanced disease, making other aspects of timely treatment that much more critically important. We therefore sought to understand the association between treatment delay at different points along the cancer care continuum and oncologic outcomes for patients with head and neck cancer. (more…)
Author Interviews, End of Life Care, Hearing Loss, JAMA / 28.09.2018

MedicalResearch.com Interview with: Tae-Min Rhee, M.D. Chief of Undersea and Diving Medicine, Underwater Medical Institute, National Maritime Medical Center, Republic of Korea Navy, Changwon Republic of Korea MedicalResearch.com: What is the background for this study? Response: The sudden sensorineural hearing loss (SSNHL) has an incidence of 5 to 20 per 100,000 person-years in the general population and sometimes results in permanent deafness followed by considerable socio-economic costs. The causes of SSNHL are often unclear, and in these cases there are no treatment of choice that is proven to be effective. In addition, spontaneous recovery is not uncommon in SSNHL, making it difficult to predict the natural course of the disease, and thus a well-controlled clinical trial is rare in spite of its clinical significance. Many treatment options (systemic or intratympanic steroids, antiviral agents, vasodilators, and hyperbaric oxygen therapy) have been suggested and tried to date, but only systemic steroid therapy has been the most effective among them. However, for the cases with contraindications to steroids, or steroid-refractory SSNHL, there is paucity of information on the second line treatment option. Hyperbaric oxygen therapy (HBOT), i.e., high-pressurized oxygen therapy, is a method of treating patients within a chamber saturated with 100% oxygen maintained at a high pressure of 2.0 to 2.5 atm. Cochlea is an organ that relies more on the diffusion of oxygen than the direct vascular supply, and thus it is known to be vulnerable to ischemia. Since this is suggested as one of the main pathophysiology of SSNHL, we wanted to prove the hypothesis that, by providing high-pressure oxygen, the partial pressure of oxygen delivered to the inner ear is maximized, and the additional or complementary therapeutic effects can be observed. A number of reports have been published for 20 years, but there is no systematically organized evidence except a Cochrane Review in 2012. Therefore, our research team tried to integrate the evidence through a comprehensive meta-analysis and to provide important clues for further research.  (more…)
Author Interviews, Cancer Research, Cost of Health Care, ENT, HPV, JAMA, Surgical Research / 18.09.2018

MedicalResearch.com Interview with: Richard B. Cannon, MD Division of Otolaryngology–Head and Neck Surgery School of Medicine University of Utah, Salt Lake City  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Patient Protection and Affordable Care Act (ACA) is a nationwide effort to reduce the number of uninsured individuals in the United States and increase access to health care. This legislation is commonly debated and objective data is needed to evaluate its impact.  As a head and neck cancer surgeon, I sought to evaluate how the ACA had specifically influenced my patients.  Main findings below:     MedicalResearch.com: What should readers take away from your report? Response: This population-based study found an increase in the percentage of patients enrolled in Medicaid and private insurance and a large decrease in the rates of uninsured patients after implementation of the Patient Protection and Affordable Care Act (ACA).  This change was only seen in states that adopted the Medicaid expansion in 2014. The decrease in the rate of uninsured patients was significant, 6.2% before versus 3.0% after. Patients who were uninsured prior to the Patient Protection and Affordable Care Act had poorer survival outcomes. (more…)
Author Interviews, ENT, Environmental Risks, Occupational Health / 06.09.2018

MedicalResearch.com Interview with: Beatrice Golomb, MD, PhD Director of the Golomb Research Group Professor of Medicine University of California, San DiegoResponse: MedicalResearch.com: What is the background for this study? How was the radiation emitted? Response: Possibilities include surveillance devices (or things to jam them), electronic weapons, or, less likely, “innocent” communications devices. MedicalResearch.com: What are the main findings? Response: That all key features of diplomats’ experiences comport with pulsed radiofrequency/ microwave (RF/MW) radiation.
  1. The nature of the “sounds” heard – chirping, clicking, ringing, grinding/buzzing – are known “sounds” produced via the “microwave auditory effect” aka Frey effect.  Different sounds are heard by different people, because the character of the sound heard depends on head dimensions (as well as pulse characteristics). Sounds were primarily heard at night: consistent with the microwave auditory effect, which requires low ambient noise. Some diplomats reported that sounds were spatially localized with “laserlike” specificity – said to defy known physics. This defies the physics of sound, but not radiation. The “sound” was reported to follow a diplomat as he walked, within the territory in which it was heard. Sound from a fixed source does not seem to follow people – but the microwave auditory affect does, often perceived as being located just behind (or in some cases just above, or inside) the head of the person, irrespective of the person’s orientation relative to the radiation source.
  2. The symptoms reported following these experiences also fit. Rates of reported symptoms in diplomats – headache, cognitive and sleep problems dominating, then dizziness, tinnitus, anxiety, nausea at lesser but still high rates – match closely with rates of the same symptoms reported in a 2012 Japanese study of people who report health effects from radiation, typically including pulsed RF/MW. Hearing loss is a relatively distinctive and prominent symptom in both diplomats, and RF/MW affected civilians. In both groups, some reportedly experience speech problems, balance problems, nosebleed, and strange sensations of vibration and pressure.
Reports of symptoms with RF/MW exposures date at least to the 1920s, affecting radio amateurs and shipboard radio operators as well as others working with radar or microwaves in occupational settings. By 1971/72, a Naval report with over 2300 citations (many from Russia and Eastern Europe), assessing effects of low intensity RF radiation, had whole sections devoted to each of a number of the symptoms diplomats report.
  1. Hundreds (if not thousands) of studies have illuminated mechanisms by which these effects may arise, centered on oxidative stress (the kind of injury that antioxidants help to defend against) – and many downstream effects of oxidative stress (membrane damage, blood brain barrier impairment with potential for brain swelling, inflammation, voltage gated calcium (and other) channel effects (which can also lead to oxidative stress), mitochondrial impairment, autoimmune activation, etc.)
Affected persons are a minority (in both settings), and in the nondiplomat setting, vulnerability has been tied to genetic variants less adept at defending against oxidative stress; and low concentrations of a critical antioxidant. In both groups, brain imaging studies resemble traumatic brain injury; and in both, at least some of those affected had prior head injury. Head injury may be a predisposing factor, as well as possible consequence. Reprising findings also shown for research on other lucrative products with potential to cause harm in some, there is a powerful tie between study results and financial conflict of interest (e.g. source of study funding or conflicts by authors).
  1. There is precedent for use of microwaves in the diplomat setting. It is known that the US embassy in Moscow was microwaved for several decades beginning in the early 1950s (with some embassy staff citing – disputed - health problems). A 1976 NY Times story (“Moscow rays linked to U.S. bugging”) referenced speculation these were for surveillance; the Soviets claimed their purpose was to thwart U.S. listening devices on the roof of the embassy.
(more…)
Author Interviews, ENT, JAMA, NIH / 17.08.2018

MedicalResearch.com Interview with: “Bad smell” by Brian Fitzgerald is licensed under CC BY 2.0Kathleen Bainbridge, PhD Epidemiology and Biostatistics Program NIDCD MedicalResearch.com: What is the background for this study? What are the main findings? Response: The causes of phantom odor perception are not understood. This study looked for the prevalence and risk factors for this disorder. We found that that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors. This study, is the first in the U.S. to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey, a continuous survey conducted by the National Center for Health Statistics which is part of the Centers for Disease Control and Prevention. The study could inform future research aiming to unlock the mysteries of phantom odors. We identified risk factors that may be related to the perception of phantom odors. People are more likely to experience this condition if they are female, and are relatively young—we found a higher prevalence in 40-60 year-olds compared to 60+ year-olds. Other risk factors include head injury, dry mouth, poor overall health, and low socio-economic status. People with lower socio-economic status may have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions. (more…)
Author Interviews, Cancer Research, ENT, HPV / 25.07.2018

MedicalResearch.com Interview with: Eric Adjei PhD, MA Saint Louis University Center for Health Outcomes Research (SLUCOR) St. Louis, Missouri  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Survivors of head and neck cancer (HNC) develop second primary cancers (SPCs) at a higher rate than most common cancers. This is concerning because the number of HNC survivors are increasing due to advancements in treatment and technology. Patients whose head and neck cancer was caused by smoking and alcohol are different than those whose HNC were caused by human papillomavirus (HPV). We therefore used data from 2000-2014 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) 18 database to examine if the incidence and the type of SPC that patients with smoking-related HNC develop were different from those from HPV-related head and neck cancer. First, independent of group of HNC (HPV-related or not), we found that SPCs among survivors of head and neck cancer were high, with about 1-in-8 patients developing an SPC. Additionally, irrespective of whether the index . head and neck cancer was from smoking-related or HPV-related, the majority of SPCs were second malignancies in head and neck region (e.g. tongue, gum, mouth floor etc), lung and esophagus. However, we observed different incidence rates between the two groups. Patients with smoking-related head and neck cancer developed SPCs at a higher rate (14%) than those with HPV-related HNC (10%). (more…)
Annals Internal Medicine, Author Interviews, ENT, Environmental Risks, Hearing Loss / 19.04.2018

Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine MedicalResearch.com Interview with: Dr. Véronique J. C. Kraaijenga MD Department of Otorhinolaryngology–Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? Response: During the past two decades, the frequency of hearing loss among young people has increased and going to music concerts, clubs and festivals may part of the reason. Noise-induced hearing loss because of recreational noise exposure is reduced by using earplugs. Our study evaluated 51 adults who attended an outdoor music festival in Amsterdam, the Netherlands, in September 2015. The study measured music festival visit for 4.5 hours (intervention); temporary hearing loss (outcome). (more…)
Author Interviews, ENT, JAMA, Surgical Research / 02.03.2018

MedicalResearch.com Interview with: Boris Paskhover, MD Rutgers New Jersey Medical School Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: Patient's and the general public routinely mention that their nose appears large, especially when they look at photos taken with their phone. I realized that patients in general are taking selfies more often nowadays. In my training, we routinely would tell patient’s not to use selfies as a marker of how they look, and we instead would take a 5ft distance photograph since we knew that is more realistic. I looked through the medical literature, and it appeared to me that no one had thoroughly discussed why selfies are a bad when evaluating the nose. I contacted a colleague at Stanford who has a PhD with interest in computer graphics and we developed a model for the face/nose. (more…)
Accidents & Violence, Author Interviews, Emergency Care, ENT, JAMA / 21.12.2017

“Qtip” by Rafael Castillo is licensed under CC BY 2.0MedicalResearch.com Interview with: Eric T. Carniol, MD, MBA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tympanic membrane perforations (aka "popped" or "burst" ear drum) is a common complaint of patients presenting to the emergency room, primary care offices, and otolaryngologist (ENT doctors) offices. These may be caused by trauma, infections, or other causes. As well, many patients will use qtips (cotton-tipped applicators) to clean ears and remove ear wax and are unaware of the potential harms of doing so. This study was designed to examine the cause of ear drum perforations as diagnosed in emergency departments in the United States. Foreign body instrumentation of the ear (qtips, hair combs, hair pins, needles, etc) were the cause of 61.2% of perforations. Cotton tip applicators are the single leading cause of traumatic tympanic membrane perforation in all age groups except young adults (13-18) and 19-36 year olds, in which it is the second largest cause (behind water trauma). Children less than 18 years old constitute nearly 2/3 of all ear drum perforations in the emergency department. (more…)
Author Interviews, ENT, Surgical Research / 22.09.2017

MedicalResearch.com Interview with: Brett A. Miles, DDS MD FACS Associate Professor of Otolaryngology Head and Neck Surgery Co-Chief Division Head and Neck Oncology Fellowship Director Head and Neck Oncologic and Microvascular Reconstructive Surgery Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ideal core temperature for patients undergoing prolonged major head and neck surgery remains unknown. Previous data indicates the low temperatures may increase the risk of developing postoperative complications such as tissue loss, hematomas, or surgical infections.(1) Other studies have indicated that high temperatures may also influence outcomes and lead to increased complications such as bleeding.(2) This study was a study of 519 patients who underwent major head and neck surgery at the Mount Sinai Hospital, New York, New York. The study looked at the core temperature of the patients during prolonged surgery for head and neck cancer in order to identify the optimal temperature range for these patients to prevent complications. The study found that higher intraoperative temperatures were associated with worse outcomes in terms of tissue loss, wound complications, and infection. Our study suggests an optimal temperature range of 35.3C-37.6C. If patients were above or below that range for a significant period of time, their complications increased. Therefore maintaining this temperature range (mild hypothermia) may improve flap outcomes in this population. (more…)
Author Interviews, Endocrinology, ENT, Surgical Research / 11.09.2017

MedicalResearch.com Interview with: Raymond L. Chai, MD Assistant Professor of Otolaryngology Icahn School of Medicine at Mount Sinai.  MedicalResearch.com: What is the background for this study? Response: Primary hyperparathyroidism is a common endocrine disorder affecting up to 1% of the general population. Surgical intervention is the only known durable cure for the disease. Untreated primary hyperparathyroidism can lead to number of health problems, including progressive osteoporosis and kidney stones. Although parathyroidectomy is a commonly performed surgical procedure by otolaryngologists, limited data exists regarding risk factors and rates of reoperation and readmission following surgery. (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern / 02.03.2017

MedicalResearch.com Interview with: Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy. (more…)
Author Interviews, Brigham & Women's - Harvard, ENT, Neurological Disorders / 30.11.2016

MedicalResearch.com Interview with: Daniel M. Merfeld, Ph.D. Professor of Otolaryngology Harvard Medical School Massachusetts Eye and Ear Director, Jenks Vestibular Physiology Laboratory Senior Scientist MedicalResearch.com: What is the background for this study? Response: Nearly half of the population will see a clinician at some point in their lives with symptoms related to the vestibular system (e.g., dizziness, vertigo, imbalance and blurred vision). The vestibular system, made up of tiny fluid-filled membranes in the inner ear, is responsible for receiving information about motion, balance and spatial orientation. With the goal of determining whether age affected the function of the vestibular system, our research team administered balance and motion tests to 105 healthy people ranging from 18 to 80 years old and measured their vestibular thresholds (“threshold” refers to the smallest possible motion administered that the subject is able to perceive correctly). (more…)
Author Interviews, Cancer Research, ENT, JAMA, Radiation Therapy, Stanford / 15.11.2016

MedicalResearch.com Interview with: Michelle M. Chen, MD/MHS Department of Otolaryngology- Head and Neck Surgery Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The benefit of post-operative radiotherapy (PORT) for patients with T1-T2 N1 oral cavity and oropharyngeal cancer without adverse pathologic features is unclear. Starting in 2014, the national guidelines no longer recommended consideration of post-operative radiotherapy for N1 oropharyngeal cancer patients, but left it as a consideration for N1 oral cavity cancer patients. We found that post-operative radiotherapy was associated with improved survival in both oral cavity and oropharyngeal cancers, particularly in patients younger than 70 years of age and those with T2 disease. (more…)
Author Interviews, Cancer Research, ENT, HPV / 04.10.2016

MedicalResearch.com Interview with: Eric M Genden, MD, FACS Isidore Friesner Professor and Chairman Department of Otolaryngology-Head and Neck Surgery The Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this report? How has the clinical picture of HPV infections of oral and throat cancers changed over the past two decades? Response: There has been no change however there has been a epidemic of viral induced throat cancer in men. The HPV virus has been established a the causative agent in cervical cancer in women. It has now been identified as a major causative agent in tonsillar and base of tongue cancer. (more…)
Author Interviews, Biomarkers, Cancer Research, ENT, HPV / 03.10.2016

MedicalResearch.com Interview with: Elizabeth Franzmann, M.D. Scientific Founder and Chief Scientific Officer Vigilant Biosciences MedicalResearch.com: What is the background for this study? Response: Head and neck cancer involves cancers of the oral cavity, oropharynx and larynx. It is difficult to treat. Part of the challenge is that it is distinguishing the patients with tumors that are going to behave aggressively from those with less aggressive disease. As a result, many patients undergo treatment that may be more intensive and morbid than they need while others need more aggressive treatment. Tissue markers associated with prognosis may be able to help clinicians differentiate patients who need more aggressive treatment from those whose treatment can be less intensive. CD44 is a cell surface glycoprotein and tumor-initiating marker. CD44 and another surface protein, EGFR, are involved in tumor extension and are associated with poor prognosis. Certain forms of Human Papillomavirus (HPV) are known to cause oropharyngeal cancer and are associated with a good prognosis. P16 is a surrogate marker for the kind of HPV that causes cancer. Understanding the relationships between how these markers are expressed in cancer tissue may direct patient treatment in the future. (more…)
Author Interviews, ENT, Surgical Research / 22.09.2016

MedicalResearch.com Interview with: Dr. Mark Courey, MD Senior Faculty,Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in voice disorders? Response: I became interested in voice disorders because during my residency in the late 1980’s there was little known about how to help patients with disorders of voice. The main instrument we use to evaluate vocal folds (the stroboscope) was just becoming clinically available. Only a handful of physicians had one available. We could not see vocal fold function and could only see the lesions on the vocal folds. We did not know how the lesions affected function. So many surgeons only treated patients with laryngeal cancer and told the others to be happy that they did not have cancer. (more…)
Author Interviews, ENT, Surgical Research / 22.09.2016

MedicalResearch.com Interview with: Eric E Smouha, MD Professor, Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in ENT and specifically middle ear problems? Response: I am a neurotologist, i.e. , ENT physician specialized in disorders of the ear and skull base. Neurotologists treat problems of the middle ear and inner ear. Middle ear problems are interesting because they are prevalent, and surgery frequently results in restoration of function. (more…)
Author Interviews, ENT, Surgical Research, Technology / 22.09.2016

MedicalResearch.com Interview with: Alfred Marc Calo Iloreta, MD Assistant Professor Skull Base Surgery and Rhinology Department of Otolaryngology - Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in ENT and your subspecialty in particular? Response: I am a ENT/Head and Neck Surgeon practicing in Manhattan at the Mount Sinai Hospital. I trained here in New York City for residency and also completed a fellowship in Rhinology and Skull Base Surgery. I chose this field and sub-specialty because of the intricate and complex anatomy of the head and neck. In addition rhinology and skull base surgery utilizes multiple advanced technologies from high definition optics, to neuronavigation to allow us to work with this complex anatomy. (more…)
Author Interviews, ENT, Surgical Research / 21.09.2016

MedicalResearch.com Interview with electrolube-surgicalTim Reese, president of Eagle Surgical Products, LLC, Sales and distribution company for Electro Lube® MedicalResearch.com: What is the background of Electro Lube®? Response: Developed in 2004, Electro Lube® is an anti-stick solution for electrosurgery designed to keep instruments clean. The product is a mixture of natural, non-synthetic, non-flammable, non-allergenic biocompatible phospholipids without any known side effects associated with patient use. (more…)
Author Interviews, JAMA, Surgical Research / 21.07.2016

MedicalResearch.com Interview with: Dr. David A. Hyman, MD Division of Otolaryngology–Head and Neck Surgery Department of Surgery University of Wisconsin School of Medicine and Public Health Madison MedicalResearch.com: What is the background for this study? What are the main findings? Response: Motor vehicle collisions represent a significant source of facial fractures seen at US trauma centers. In the last few decades there have been significant advances in airbag technology as well as a national legislative push regarding seat belt use which has led to increased safety device use. With these trends, we sought to assess the incidence of facial fractures in patients who present to US trauma centers as well as to analyze what effect restraint devices have on the likelihood of facial fractures after motor vehicle collisions. This analysis was performed using National Trauma Data Bank data from 2007-2012. We found the incidence of at least one facial fracture after a motor vehicle collision was 10.9% with nasal fracture being the most common facial fracture. Based on our analysis of more than 56 thousand patients with a facial fracture, we found that use of an airbag alone reduced the likelihood of a facial fracture by 18% while use of a seat belt alone reduced likelihood by 43%. Use of both reduced the likelihood of facial fractures in a crash by 53%. Younger age, male sex, and use of alcohol increased the likelihood of facial fracture. (more…)
Author Interviews, JAMA / 01.07.2016

MedicalResearch.com Interview with: Christopher Badger, MS3 PRIME-LC UC Irvine School of Medicine MedicalResearch.com: Which over-the-counter mechanical nasal dilators are effective at relieving nasal valve obstruction? Response: In this systemic review, 33 over-the-counter mechanical nasal dilators were identified and classified by mechanism. Ten peer reviewed articles identified six effective devices. MedicalResearch.com: What should readers take away from your report? Response: External nasal dilators and nasal clips may be an effective treatment for the relief of nasal valve obstruction. (more…)
Author Interviews, JAMA, Johns Hopkins, Surgical Research / 15.03.2016

MedicalResearch.com Interview with: Shaun C. Desai, MD Assistant Professor Facial Plastic and Reconstructive Surgery Department of Otolaryngology - Head & Neck Surgery Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Desai: Estimates of the rate of revision septorhinoplasty and the risk factors associated with revision are unknown because the current published literature is limited to small, retrospective, single-surgeon studies with limited follow-up time. The purpose of this study is to determine the overall revision rates of patients undergoing a septorhinoplasty procedure (for functional or cosmetic reasons) and to determine risk factors for the revision. We found that the overall revision rate was 3.3% (5,775 patients of a total of 175,842 patients undergoing the procedure) with an average time to revision at 1 year. Risk factors for revision surgery included female gender, younger age, a history of anxiety or autoimmune disease, cosmetic indications, and more complicated initial surgery (i.e. cleft rhinoplasty). (more…)
Author Interviews, Infections, JAMA, Microbiome / 24.12.2015

MedicalResearch.com Interview with: Tara F Carr, MD Assistant Professor, Medicine and Otolaryngology Allergy and Immunology Fellowship Training Program Director Director, Adult Allergy Division of Pulmonary, Allergy, Critical Care and Sleep Medicine University of Arizona Tucson, AZ 85724 Medical Research: What is the background for this study? What are the main findings? Dr. Carr: Some patients with chronic rhinosinusitis continue to suffer from symptoms despite aggressive medical and surgical treatments. For these individuals, therapy is generally chosen based on bacterial culture results, and often includes the use of topical antibacterial rinses with a medication called mupirocin.  We found that if patients are still having problems after this treatment, the bacteria identified from repeated sinus cultures are very different than those usually expected, and in general more difficult to treat. (more…)