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A novel indocyanine green-based fluorescent marker for guiding surgical tumor resection

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Journal of Innovative Optical Health Sciences 2021年第3期4卷 77-87页

作者： Jiawei Ge Justin D.Opfermann Hamed Saeidi Katherine A.Huenerberg Christopher D.Badger Jaepyeong Cha Martin J.Schnermann Arjun S.Joshi Axel Krieger Department of Mechanical Engineering Johns Hopkins university BaltimoreMD 21218USA Department of Mechanical Engineering university of Maryland College Park MD 20742USA Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital WashingtonDC 20010USA Department of Pathology george washington university WashingtonDC 20052USA division of otolaryngology-head and neck surgery george washington university washington DC 20052USA Chemical Biology Laboratory Center for Cancer Research National Cancer InstituteNational Institutes of HealthFrederickMD 21702USA

Surgical tumor resection is a common approach to cancer *** Ink tattoos are widely used to aid tumor resection by localizing and mapping the tumor edge at the ***,India Ink tattoos are easily obscured during electrosurgical resection,and fade in intensity over *** this work,a novel near-infrared(NIR)fluorescent marker is introduced as an *** NIR marker was made by mixing indocyanine green(ICG),biocompatible cyanoacrylate,and *** marking strategy was evaluated in a chronic ex vivo feasibility study using porcine tissues,followed by a chronic in vivo mouse study while compared with India *** both studies,signal-to-noise(SNR)ratios and dimensions of the NIR markers and/or India Ink over the study period were calculated and *** was performed on the last day of the mouse study after mice were euthanized,and SNR ratios and dimensions were quantified and *** was performed at all injection sites and slides were examined by a *** proposed NIR marker achieved(i)consistent visibility in the 26-day feasibility study and(ii)improved durability,visibility,and biocompatibility when compared to traditional India Ink over the six-week period in an in vivo mouse *** effects persist after electrocautery whereas the India Ink markers were *** use of a NIR fluorescent presurgical marking strategy has the potential for intraoperative tracking during long-term treatment protocols.

关键词： Near-infrared fluorescent marker surgical tumor resection fluorescence-guided sur-gery electrosurgery India ink

Complications associated with energy-based devices during thyroidectomy from 2010–2020

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World Journal of Otorhinolaryngology-head and neck surgery 2023年第1期9卷 35-44页

作者： Esther Lee Jane Y.Tong Luke J.Pasick Daniel A.Benito Arjun Joshi Punam G.Thakkar Joseph F.Goodman division of otolaryngology-head and neck surgery George Washington University School of Medicine&amp Health SciencesWashingtonDCUSA Western university of Health Sciences PomonaCAUSA Department of otolaryngology-head and neck surgery Drexel University College of MedicinePhiladelphiaPAUSA Department of otolaryngology-head and neck surgery University of Miami Miller School of MedicineMiamiFLUSA

Objective:Harmonic Focus(Ethicon,Johnson and Johnson,Cincinnati,OH,USA),LigaSure Small Jaw(Medtronic,Covidien Products,Minneapolis,MN,USA),and Thunderbeat Open Fine Jaw(Olympus,Japan)are electrosurgical instruments used widely in head and neck *** study aims to compare device malfunctions,adverse events to patients,operative injuries,and interventions related to Harmonic,LigaSure,and Thunderbeat use during ***:The US Food and Drug Administration's Manufacture and User Facility Device Experience(MAUDE)database was queried for adverse events associated with Harmonic,LigaSure,and Thunderbeat from January 2005 to August *** were extracted from reports pertaining to ***:Of the 620 adverse events extracted,394(63.5%)involved Harmonic,134(21.6%)LigaSure,and 92(14.8%)*** reported device malfunctions most frequently associated with Harmonic was damage to the blade(110(27.9%)),LigaSure was inappropriate function(47(43.1%)),Thunderbeat was damage to the tissue or Teflon pad(27(30.7%)),*** injury and incomplete hemostasis were the most commonly reported adverse *** operative injury reported most frequently when using Harmonic and LigaSure was burn *** operator injuries were reported with Thunderbeat ***:The most frequently reported device malfunctions were damage to the blade,inappropriate function,and damage to the tissue or Teflon *** most frequently reported adverse events to patients was a burn injury and incomplete *** aimed at improving physician education may help reduce adverse events attributed to improper use.

关键词： Adverse events Harmonic LigaSure Manufacture and User Facility Device Experience Patient safety Quality Thunderbeat Thyroidectomy

Synovial osteochondromatosis of the temporomandibular joint: A case report

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World Journal of Otorhinolaryngology 2019年第2期8卷 12-18页

作者： Nahir Romero Collin F Mulcahy Stephanie Barak Muhammed F Shand Christopher D Badger Arjun S Joshi Department of surgery Division of OtolaryngologyHead and Neck SurgeryGeorge Washington University HospitalWashingtonDC 20037United States Department of Pathology George Washington University HospitalWashingtonDC 20037United States george washington university School of Medicine and Health Sciences WashingtonDC 20037United States

BACKGROUND Synovial osteochondromatosis is a rare but benign condition that can result in significant impairment of joint *** case report documents an uncommon presentation of this disorder occurring within the temporomandibular joint,causing the patient significant pain,trismus,and difficulty with daily activities such as eating and speaking.A review of the literature including disease mechanisms and previously documented cases is included to provide comprehensive background for clinical *** SUMMARY A 48-year-old male patient presented with a 3-mo history of trismus,crepitus with jaw movement and significant pain while *** examination revealed a firm mass and tenderness to palpation at the right temporomandibular *** workup revealed a bilobed mass extending into the joint space as well as significant bony erosion of the glenoid *** patient underwent mass excision with joint reconstruction and pathology revealed synovial *** patient reported significant improvement in his symptoms *** This report outlines the investigative approach and treatment course of synovial *** positive outcome following surgical intervention in this case emphasizes the importance of interdisciplinary collaboration and the potential for improvement in quality of life of this patient population.

关键词： Osteochondromatosis Temporomandibular joint Mandible Resection Case report

Does reconstruction affect outcomes following exclusively endoscopic endonasal resection of benign orbital tumors: A systematic review with meta-analysis

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World Journal of Otorhinolaryngology-head and neck surgery 2022年第1期8卷 25-35页

作者： Ashton E.Lehmann Manuela von Sneidern Sarek A.Shen Ian M.Humphreys Waleed M.Abuzeid Aria Jafari Department of otolaryngology-head and neck surgery Vanderbilt University Medical CenterNashvilleTennesseeUSA Department of otolaryngology-head and neck surgery Geisinger Medical CenterDanvillePennsylvaniaUSA Department of otolaryngology-head and neck surgery New York University School of MedicineNew YorkNew YorkUSA Department of otolaryngology-head and neck surgery Johns Hopkins HospitalBaltimoreMarylandUSA division of Rhinology and Endoscopic Skull Base surgery Department of Otolaryngology-Head and Neck SurgeryUniversity of WashingtonSeattleWashingtonUSA

Objective:As exclusively endoscopic endonasal resection of benign orbital tumors has become more widespread,high-quality outcomes data are lacking regarding the decision of when and how to reconstruct the medial orbital wall following *** goal of this study was to systematically review pertinent literature to assess clinical outcomes relative to orbital reconstruction ***:Data Sources:PubMed,EMBASE,Web of Science.A systematic review of studies reporting exclusively endoscopic endonasal resections of benign orbital tumors was *** not reporting orbital reconstruction details were *** and tumor characteristics,operative details,and outcomes were *** were compared usingχ^(2),Fisher’s exact,and independentt ***:Of 60 patients included from 24 studies,34(56.7%)underwent orbital reconstruction following *** most common types of reconstruction were pedicled flaps(n=15,44.1%)and free mucosal grafts(n=11,32.4%).Rigid reconstruction was uncommon(n=3,8.8%).Performance of orbital reconstruction was associated with preoperative vision compromise(P<0.01).The tendency to forego orbital reconstruction was associated with preoperative proptosis(P<0.001),larger tumor size(P=0.001),and operative exposure of orbital fat(P<0.001)and extraocular muscle(P=0.035).There were no statistically significant differences between the reconstruction and nonreconstruction groups in terms of short-or long-term outcomes when considering all *** patients with intraconal tumors,however,there was a higher rate of short-term postoperative diplopia when reconstruction was foregone(P=0.041).This potential benefit of reconstruction did not persist:At an average of two years postoperatively,all patients for whom reconstruction was foregone either had improved or unchanged ***:Most outcomes assessed did not appear affected by orbital reconstruction *** general equivalence may suggest that orbit

关键词： cavernous hemangioma diplopia endoscopic endonasal surgery enophthalmos meningioma orbital reconstruction orbital tumor outcomes schwannoma

Anxiety and depression in spasmodic dysphonia patients

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World Journal of Otorhinolaryngology-head and neck surgery 2018年第2期4卷 110-116页

作者： Amanda Hu Al Hillel Wei Zhao Tanya Meyer division of otolaryngology — head & neck surgery Department of Surgery University of British Columbia Vancouver Canada Department of otolaryngology — head & neck surgery University of Washington Seattle WA USA Albert Einstein College of Medicine Bronx NY USA

Objective/Hypothesis: Experts used to believe that spasmodic dysphonia (SD) was a psychogenic disorder. Although SD is now established as a neurological disorder, the rates of co-morbid anxiety and depression range from 7.1％ to 62％. Our objective was to study the prev-alence and risk factors associated with these mood disorders in SD patients. Study design: Retrospective. Methods: SD patients who presented for botulinum toxin injections were recruited. Demo-graphic data, Hospital Anxiety and Depression Scale (HADS), Voice Handicap Index-10 (VHI-10), General Self-Efficacy scale (GSES), Disease Specific Self-Efficacy in Spasmodic Dysphonia scale (DSSE), and Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) were collected. Results: One hundred and forty two patients (age (59.2 ± 13.6) years, 25.4％ male) had VHI-10 of 26.3 ± 6.9 (mean ± standard deviation), GSES 33.2 ± 5.8, CAPE-V 43.9 ± 20.9, HADS anxiety 6.7 ± 3.7, and HADS depression 3.6 ± 2.8. About 19 (13.4％) and 4 (2.8％) had symptoms of anx-iety and depression respectively. Final linear regression model for HADS anxiety (R2 = 32.90％) showed that patients who were less likely to have anxiety symptoms were older age (p < 0.001), male (p = 0.002), have higher GSES (p < 0.001) and lower VHI-10 (p = 0.004). Final linear regression model for HADS depression score (R2 = 34.42％) showed that patients who were less likely to have depressive symptoms had high DSSES (p < 0.001). Conclusions: Prevalence of anxiety (13.4％) and depression (2.8％) in SD were lower than previ-ously reported in the literature. Risk factors for anxiety were: younger age, female gender,lower general self-efficacy, and higher perceived vocal handicap. The main risk factor for depression was lower disease specific self-efficacy.

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The distribution of parotid gland neoplasms in a veteran population

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World Journal of Otorhinolaryngology-head and neck surgery 2021年第4期7卷 285-290页

作者： Adnan S.Hussaini Navin R.Prasad Edina Paal Eshetu A.Tefera Sonya Malekzadeh Jessica H.Maxwell MedStar georgetown university Hospital Department of OtolaryngologyHead and Neck SurgeryWashingtonDCUSA georgetown university School of Medicine WashingtonDCUSA washington DC Veterans Affairs Medical Center WashingtonDCUSA The george washington university Department of PathologyWashington DCUSA MedStar Health Research Institute-Department of Biostatistics and Biomedical Informatics HyattsvilleMDUSA

Objective:Salivary gland tumors account for 6%-8%of head and neck neoplasms with the parotid gland as the most common primary *** adenomas(PA)are considered the most common benign parotid gland neoplasms,followed by Warthin tumors(WT).The goal of this study was to investigate the distribution of parotid gland neoplasms among a United States veteran ***:Retrospective chart ***:washington DC Veterans Affairs Medical ***:Veterans who underwent fine needle aspiration(FNA)for a parotid gland mass from 2000 to 2018 were *** records were reviewed for gender,age,tobacco use,surgery date,and pathology *** outcome measures:Changes in the distribution of parotid neoplasms and tobacco use over an 18-year ***:Of 141 patients with parotid gland masses,86.5%(n=122)were benign,9.9%(n=14)were malignant,and 3.5%(n=5)were *** benign tumors,WT accounted for the majority at 51.6%,followed by PA at 40.2%.When stratified by decade(2000-2009 and 2010-2018),the proportion of WT compared to all other benign and malignant neoplasms increased from 31.6%to 53.6%,whereas the proportion of PA decreased from 36.8%to 33.3%.The rate of tobacco use was unchanged at approximately 32.0%among our cohort from 2000 to ***:Among our cohort of veteran patients,WT was the most common benign parotid tumor and has increased in incidence over the last two decades despite an unchanged smoking rate.

关键词： Parotid neoplasm Warthin tumor Pleomorphic adenoma Tobacco head and neck cancer Veteran