Mild Hypothermia During Prolonged Surgery May Reduce Complications

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

Dr. Miles

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.

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Risk Factors For Reoperation and Readmission After Parathyroidectomy Identified

MedicalResearch.com Interview with:

Raymond L. Chai, MD Assistant Professor of Otolaryngology Icahn School of Medicine at Mount Sinai.

Dr. Rai

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.

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Obstructive Sleep Apnea More Common In Obese Adolescents With Enlarged Tonsils

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

Dr. Ron Mitchell

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.

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Vestibular or Inner Ear System Weakens After Age 40

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

Dr. Daniel M. Merfeld

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).

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Post-Op Radiotherapy Improved Survival In Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

MedicalResearch.com Interview with:

Michelle M. Chen, MD/MHS Department of Otolaryngology- Head and Neck Surgery Stanford University

Dr. Michelle Chen

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.

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Epidemic of HPV Associated Throat Cancer in Men

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

Dr. Eric Genden

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.

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Cell Biomarkers To Distinguish Deadly From Less Aggressive HPV Oral Cancers

MedicalResearch.com Interview with:

Elizabeth Franzmann, M.D. Scientific Founder and Chief Scientific Officer Vigilant Biosciences

Dr. Elizabeth Franzmann

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.

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Decision-Making in Laryngology: Both Sides of the Story

MedicalResearch.com Interview with:

Senior Faculty,Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai

Dr. Mark Courey

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.

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ENT Surgeon Manages Middle Ear Cholesteatoma Removal In One Surgical Procedure

MedicalResearch.com Interview with:

Eric E Smouha, MD Professor, Otolaryngology The Mount Sinai Hospital New York Eye and Ear Infirmary of Mount Sinai

Dr. Eric E Smouha

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.

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3D Models and Immersive Virtual Reality Simulation for Complex Skull Base Surgery

MedicalResearch.com Interview with:

Alfred Marc Calo Iloreta

Dr. Alfred Marc Calo Iloreta

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.

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An answer for eschar buildup: anti-stick solution for electrosurgery

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.
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Over 50% Reduction in Facial Fractures from Car Accidents With Combined Seat Belt and Air Bag use

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.

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Some Over-the-Counter Nasal Strips and Clips Found To Be Effective Dilators

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.

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About 3% of Rhinoplasty Surgeries Require Revision

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

Dr. Shaun Desai

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).

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Topical Mupirocin Changes Sinus Microbiome

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

Dr.  Carr

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.

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Tumor DNA In Saliva and Plasma May Be Biomarker For Head and Neck Cancer

Nishant Agrawal M.D. Associate Professor of Otolaryngology Johns Hopkins University School of MedicineMedicalResearch.com Interview with:
Nishant Agrawal M.D.

Associate Professor of Otolaryngology
Johns Hopkins University School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Agrawal: The idea of the study really arose from the specificity of genetic changes that characterize and are the hallmark of cancer cells.  Only cancer cells contain these mutations so their detection in bodily fluids was a reasonable expectation.  The current study builds on previous work from our group that tumor DNA can be detected in the bodily fluids of patients with many different types of solid malignancies.  The main findings of the study are that tumor DNA in saliva and plasma provides a non-invasive biomarker for head and neck cancer.  The take home message is that tumor DNA has potential to be used as a biomarker for screening, early detection, monitoring during treatment, and surveillance after cancer treatment is completed.

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