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Publications (3)4.46 Total impact

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    ABSTRACT: The aim of this study was to study the effect of stenting with a silastic sheet on the long-term patency of the common frontal ostium after an endoscopic modified Lothrop procedure (EMLP). A retrospective analysis was performed of prospectively collected data at an academic tertiary referral center, where 72 patients underwent an EMLP between 1996 and 2003. Patency of the common frontal ostium was studied as an ordinal variable with three classes (patent, stenotic, and closed). A common ostium was endoscopically visualized in 94% of the patients (61.1% patent and 33.3% stenotic). Symptoms improved in 75% of the patients. A significant positive correlation was found between ostium patency and symptom improvement. Twenty-five patients were stented postoperatively. There was no statistical difference between the stented and the nonstented groups with regards to ostium patency and symptoms improvement. Short-term stenting does not appear to reduce the rate of postoperative stenosis of the common frontal ostium after an EMLP.
    American Journal of Rhinology 01/2006; 20(6):595-9. · 1.36 Impact Factor
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    ABSTRACT: This study examines the presence of atypical bacteria in chronic rhinosinusitis (CRS) by utilizing the polymerase chain reaction (PCR). Eleven patients with CRS were prospectively enrolled. DNA was isolated from the mucosa samples and subjected to PCR using oligonucleotides specific for identification of atypical bacteria including: Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. Also, routine aerobic and anerobic cultures were processed. Sinus tissue samples from 6 fresh corpses without evident sinus disease served as controls. No atypical bacteria were identified in the 11 patient samples by PCR. One of 6 cadaver controls was positive by PCR for M pneumoniae. The most common organism obtained from routine culture was coagulase negative staphylococci. Using sensitive PCR techniques, CRS mucosa did not reveal DNA from M pneumoniae, C pneumoniae, or L pneumophila. Atypical bacteria were not identified in patients with CRS despite highly effective PCR methods and they may not play a significant role in the cause of CRS.
    Otolaryngology Head and Neck Surgery 10/2005; 133(3):407-10. · 1.73 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the efficacy and safety of endoscopically resecting paranasal sinus inverted papillomas at a tertiary medical center. Over a 9-year period, 51 patients with a diagnosis of inverted papilloma underwent endoscopic resection at the University of Miami/Jackson Memorial Medical Center. The study group consisted of 14 women and 37 men with a mean age of 59 years (range, 20-88 years) enrolled in a clinical data base. All of the patients were followed endoscopically at regular intervals on an outpatient basis. Endoscopic evidence of extensive papillomas involving the anterior and posterior ethmoid sinuses and at least one (usually the maxillary) dependent sinus was found in 60% of the cases. Extensive radiological disease (varying degrees of mucoperiosteal thickening or opacification of all five cavities) was evident in 50% of the cases. All but two had unilateral disease. An association with chronic inflammatory polyps (clinically and pathologically) was observed in 25 of 51 patients (49%). Follow-up ranged from 6 to 99 months (mean, 30 months). There have been seven recurrences (14%). Four of these have been managed in the office under topical anesthesia. Three recurrences were managed surgically in the operating room. All of the patients have been free of disease. Complications included an intraoperative CSF leak (three patients); temporary infraorbital hypesthesia (three patients); periorbital ecchymosis, hematoma, or cheek edema (four patients); and orbital symptoms (two patients). Carcinoma was found in four patients (8%) who received postoperative radiotherapy and remain free of disease. The endoscopic approach continues to provide at least equivalent short-term results as compared with external techniques for the removal of paranasal sinus inverted papilloma. The final cavity should allow for adequate postoperative surveillance and potential resection of recurrences in the office setting, without the need for a return to the operating room in most patients. The association of inverted papilloma with chronic inflammatory polyps and tobacco use warrants additional study.
    American Journal of Rhinology 17(4):185-90. · 1.36 Impact Factor