Massi Romanelli-Gobbi

Thomas Jefferson University, Philadelphia, PA, United States

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Publications (4)12.58 Total impact

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    ABSTRACT: This article discusses the use of an integrative approach to treating tinnitus. The authors begin with a discussion of their approach to tinnitus patients, followed by a detailed look at the physiology of tinnitus and several theories of its mechanism. The many viable options for tinnitus relief are discussed, including sound therapies, Western medical approaches, and herbal and traditional medicines that can be used as integrative and complementary treatments. It concludes with a reminder that a variety of treatment options are available to tinnitus patients to help them take control of their symptoms.
    Otolaryngologic Clinics of North America 06/2013; 46(3):389-408. · 1.46 Impact Factor
  • Carol L Shields, Massi Romanelli-Gobbi, Sara E Lally, Jerry A Shields
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    ABSTRACT: Two asymptomatic elderly women who underwent cataract extraction 7 or more years previously and with intraocular lens placement presented with a linear bead-like white multinodular mass in the inferior angle simulating iris metastasis versus large inflammatory precipitates. There was no iris infiltration. In the first case, the posterior lens capsule was intact and there was no evidence of gelatinous vitreous in the anterior chamber, whereas in the second case, the capsule was open and there was gelatinous vitreous prolapse. In both cases, there was asteroid hyalosis in the vitreous. Both patients were diagnosed with prolapsed vitreous asteroid hyalosis into the anterior chamber and managed with observation. Vitreous asteroid hyalosis can prolapse into the anterior chamber of pseudophakic elderly patients with or without capsular opening and can simulate an intraocular tumor.
    Middle East African journal of ophthalmology 07/2012; 19(3):346-8.
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    ABSTRACT: To compare ultrasound biomicroscopy (UBM) versus anterior segment optical coherence tomography (AS-OCT) for imaging of tumors of the anterior segment of the eye. Retrospective, noninterventional case series. We included 200 patients. Review of medical records of patients who underwent both UBM and AS-OCT for evaluation of anterior segment tumors. Comparison of tumor surface and internal visualization. There were 200 eyes with anterior segment tumors involving the iris stroma in 96 (48%), ciliary body in 14 (7%), combined iris and ciliary body in 32 (16%), iris pigment epithelium (IPE) in 44 (22%), conjunctiva in 6 (3%), sclera in 4 (2%), and others in 6 (1% each). The diagnoses included nevus in 75 eyes (38%), melanoma in 47 (24%), cyst in 48 (24%), epithelioma (adenoma) in 5 (3%), metastasis, melanocytosis and melanocytoma in 4 eyes each (2%), and others (1% each). Image analysis (UBM vs AS-OCT) revealed adequate visualization of all tumor margins (189 [95%] vs 80 [40%]), posterior tumor shadowing (9 [5%] vs 144 [72%]), and high overall image quality (159 [80%] vs 136 [68%]). Comparison for better image resolution (UBM vs AS-OCT) disclosed UBM provided better overall tumor visualization (138 [69%] vs 62 [31%]) and better resolution of the posterior margin (147 [74%] vs 53 [27%]), whereas AS-OCT provided better resolution of the anterior margin (40 [20%] vs 160 [80%]) as well as better overall resolution of anterior segment anatomy (41 [21%] vs 159 [80%]). Better resolution was found with UBM for pigmented tumors (n = 162; 107 [66%] vs 55 [34%]) as well as for nonpigmented tumors (n = 38; 23 [61%] vs 15 [39%]). Regarding location, iris tumor resolution was similar with each technique (49 [52%] vs 45 [48%]). For anterior segment tumors, UBM offers better visualization of the posterior margin and provides overall better images for entire tumor configuration compared with AS-OCT.
    Ophthalmology 03/2011; 118(7):1297-302. · 5.56 Impact Factor
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    ABSTRACT: To evaluate conjunctival nevi using anterior segment optical coherence tomography (AS-OCT). Retrospective interventional case series. There were 22 eyes of 21 patients with conjunctival nevus imaged with AS-OCT for evaluation and detection of cysts within conjunctival nevi. Anterior segment OCT. Evaluation and detection of intralesional cysts. All margins of the nevus, including the deep margin, could be visualized on AS-OCT with high resolution of the anterior margin in 100% of cases, posterior margin in 82% of cases, and lateral margin in 86% of cases. The nevus was optically dense with homogeneous pattern in all cases. Some degree of deep optical shadowing, mostly from pigmented nevi, was noted in 86%. Intrinsic cysts within the nevus were detected by slit-lamp biomicroscopy in 18 cases (82%) and by AS-OCT in 17 cases (77%). In comparison with histopathologic findings, AS-OCT detected intrinsic cysts with a sensitivity of 80%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 60%. Slit-lamp biomicroscopy (by experienced observers) compared with histopathology revealed detection of cysts with a sensitivity of 100%, a specificity of 100%, a PPV of 100%, and an NPV of 100%. Anterior segment OCT provides high-resolution imaging of conjunctival nevi with the ability to demonstrate all margins and to provide information on the presence of intralesional cysts, which are important in the diagnosis. The main drawback is optical shadowing of deeper structures from pigment within nevi.
    Ophthalmology 12/2010; 118(5):915-9. · 5.56 Impact Factor