Airway Complications from Topical Mitomycin C

2005 ◽  
Vol 133 (6) ◽  
pp. 831-835 ◽  
Author(s):  
Elizabeth McCurdy Hueman ◽  
C. Blake Simpson
Keyword(s):  
Mitomycin C ◽  
Animal Studies ◽  
Chart Review ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Airway Stenosis ◽  
Local Toxicity ◽  
Included Patient ◽  
And Gender

OBJECTIVE: Topical application of mitomycin C appears to be a useful adjunct in reducing cicatricial scarring of the airways. Human and animal studies have demonstrated the efficacy and safety of mitomycin C topically in the treatment of airway stenosis at concentrations ranging from 0.4 mg/mL to 10 mg/mL. Although no reports of mitomycin C toxicity have been reported in the otolaryngology literature, the ophthalmologic literature has documented serious, vision-threatening complications resulting from the use of topical mitomycin C. The purpose of this study is to report complications related to mitomycin C use in the treatment of glottic and subglottic stenosis. Risk factors associated with these complications are identified. STUDY DESIGN AND SETTING: A retrospective chart review of all patients treated by the senior author for laryngotracheal stenosis with endoscopic CO2 laser incisions/dilation and adjuvant topical mitomycin C was performed to determine the incidence of complications. Variables studied included patient age and gender, location and severity of stenosis, medical comorbidities, length of procedure, postoperative instrumentation of the airway, and mitomycin C concentration. RESULTS: Eighty-five cases of adjuvant topical mitomycin C use after CO2 laser endoscopic treatment and dilation for upper airway stenosis were identified in a total of 44 patients. Complications that were believed to be caused by the local toxicity of mitomycin C occurred in 4 cases out of 85 (or 4.7%), manifested by accumulation of fibrinous debris at the operative site, resulting in partial airway obstruction and the need for emergent airway intervention. CONCLUSIONS: Caution should be exercised when topical mitomycin C is used in the treatment of airway stenosis. EBM RATING: B-3

scholarly journals P.138 Minimally invasive treatment of syringomyelia using tubular retractors

2018 ◽  
Vol 45 (s2) ◽  
pp. S53-S53
Author(s):  
K Yang ◽  
M Sourour ◽  
N Zagzoog ◽  
K Reddy
Keyword(s):  
Minimally Invasive ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Invasive Technique ◽  
Single Center ◽  
Invasive Treatment ◽  
Multiple Modalities ◽  
Subarachnoid Spaces

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.

A Comparison of Sexual Arousal in Men Exposed to Visual Stimuli With and Without Facial Blurring

Sexual Abuse ◽  
2019 ◽  
Vol 32 (6) ◽  
pp. 619-633 ◽  
Author(s):  
Leah Rosetti ◽  
Susan Curry ◽  
Lisa Murphy ◽  
John B. Bradford ◽  
J. Paul Fedoroff
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Effect Sizes ◽  
Modest Effect Size ◽  
Legal Challenges ◽  
And Gender ◽  
Gender Categories ◽  
Facial Images ◽  
Modest Effect

The role of the facial images in arousal and attraction has been examined before but never via penile plethysmography (PPG). This retrospective chart review aimed to determine the significance and magnitude of differences in arousal measured by PPG in 1,000 men exposed to slide stimuli with or without facial blurring in subjects of various ages. Arousal in response to blurred stimuli was significantly higher than nonanonymized stimuli with modest effect sizes for slides across age and gender categories. Facial blurring increased differences in arousal between adults and adolescents with a modest effect size. Our findings support the use of facial blurring to further protect the anonymity of models and limit the ethical and legal challenges of using slide stimuli with child models.

scholarly journals Influence of Endothelin-1 in Aqueous Humor on Intermediate-Term Trabeculectomy Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Lars Choritz ◽  
Benjamin Mahmoodi ◽  
Hagen Thieme
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Aqueous Humor ◽  
Complication Rate ◽  
Surgical Outcome ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Glaucoma Medication ◽  
Surgical Success ◽  
Endothelin 1

Purpose. To investigate whether increased concentrations of ET-1 in aqueous humor of glaucoma patients influences surgical outcome of standard trabeculectomy with Mitomycin C.Methods. Retrospective chart review of 36 glaucoma patients with known ET-1 concentrations who had undergone trabeculectomy with Mitomycin C. Patients were divided into two groups based on their aqueous ET-1 concentration, a below-median (low ET-1) and an above-median (high ET-1) group. Postoperative IOP development, necessity of glaucoma medication, surgical success and complications, postoperative use of antifibrotics (5-FU), and number of additional glaucoma surgeries were compared between the groups.Results. Overall surgical success of trabeculectomy was comparable to published literature (90%, 81%, 76%, and 68% absolute success at 12, 24, 36, and 48 months after surgery). There was no difference between high and low ET-1 group in the postsurgical development of IOP, surgical success rate, or complication rate. There was no difference in postoperative scarring or indirect indicators thereof (e.g., number of 5-FU injections, needlings, suture lyses, or IOP lowering medications).Conclusion. In this set of patients, ET-1 in aqueous humor does not appear to have influenced surgical outcome of trabeculectomy with Mitomycin C. There is no indication of an increased likelihood of bleb fibrosis in patients with increased ET-1 concentrations.

Factors Associated With Patient Nonattendance in Rhinology Clinics

2019 ◽  
Vol 33 (3) ◽  
pp. 317-322
Author(s):  
Benjamin N. Hunter ◽  
Brandon Cardon ◽  
Gretchen M. Oakley ◽  
Arun Sharma ◽  
Dana L. Crosby
Keyword(s):  
Chart Review ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Patient Demographics ◽  
Medical Centers ◽  
Insurance Type ◽  
Academic Medical ◽  
Included Patient

Background Nonattendance to clinical appointments is a global problem appreciated by clinicians with an ambulatory presence. There are few reports of nonattendance in otolaryngology clinics, and no reports on nonattendance for a single otolaryngology subspecialty. Objective To describe the no-show population in rhinology clinics. Methods A retrospective chart review was performed involving rhinology clinics from 2 academic medical centers in the United States. All patients who either attended their clinic appointment(s) or did not attend without previously cancelling from June 2016 to May 2017 were included. Data collected included patient demographics, appointment status, season and time of visit, insurance status, type of visit (new vs established), and provider seen. Results There were 2791 clinical appointments evaluated over a 12-month period at 2 rhinology clinics involving 4 fellowship-trained rhinologists. Ninety-two percent of patients kept their appointments, while 8% did not. Sex, season of visit, time of visit (am vs pm), type of visit, provider sex, provider location, or provider’s experience (<10 years vs ≥10 years) were not associated with patient’s attendance status. Univariate analysis showed that patient’s age ≤50 ( P = .001) and primary insurance type ( P < .001) were associated with nonattendance. Medicaid as the primary insurance type was associated with clinic nonattendance. Multivariable analysis showed that age ≤ 50 years, odds ratio (OR) 1.62 (95% confidence interval [CI] 1.14–2.30), P = .007, and primary insurance type (Medicaid: OR 3.75 [95% CI 2.58–5.45], P < .001) remained significant predictors of nonattendance. Conclusion Patients younger than 50 years and patients with Medicaid as the primary insurance types are associated with risk of missing rhinology clinic appointments. As a subspecialty, delivery of timely care and clinical efficiency could be improved by interventions directed toward improving attendance among this population.

Unique perspectives from the transgender community: A retrospective chart review of cancer care needs for transgender patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6566-6566
Author(s):  
Carolyn Moloney ◽  
Margaret Allen ◽  
Deirdre O'Mahony ◽  
Derek Power ◽  
Richard Bambury ◽  
...  
Keyword(s):  
Cancer Care ◽  
Medical Records ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Well Being ◽  
Smoking History ◽  
Desmoid Tumour ◽  
Cancer Support ◽  
Incidence And Mortality ◽  
And Gender

6566 Background: It is estimated that 1% of a population experience some degree of gender non-conformity. There is scant information worldwide on cancer incidence and mortality for this population however due to a lack of investigating large-scale prospective studies. National cancer registries do not hold demographics on this population. Current literature indicates transgender people may face an increased cancer risk. Transgender patients may avoid screening programmes for cancers which are themselves gendered. Transgender patients can feel excluded from gender specific cancer support groups. We set out to identify how cancer services in Ireland can better meet transgender people’s unique needs. Methods: Medical oncology consultants in the South/South-West of Ireland were contacted to identify patients who identified as transgender or gender non-conforming. We carried out a retrospective chart review of the four transgender patients identified. We analysed staging at diagnosis, family supports, smoking history, alcohol use and whether cancer treatment affected gender transitioning treatment and if this had documented effects on mental well-being. We also noted if medical records reflected a new name or change of gender and if not, whether original name and gender used for chemotherapy and blood product administration. Results: All four patients were diagnosed with relatively advanced disease at diagnosis- Stage IIIc high grade ovarian cancer, stage IV gastrointestinal tumour, stage IVb diffuse large B Cell and locally advanced extra-abdominal desmoid tumour. Of the four patients, three had a smoking and alcohol history on diagnosis. All four patient’s recent medical correspondence reflected a name and gender change but the medical records did not reflect this. Three patients had documented depression for which they were attending psychiatry services. It was noted that two patients had gender transitioning treatment postponed due to cancer care. Minimal family support was noted for two patients. Conclusions: The transgender community is a growing population that will continue to integrate into mainstream society. Our retrospective chart review adds to a growing body of evidence which suggests gender minorities may suffer from cancer-related disparities and have an increased need for psychosocial support. As in other studies, it is difficult to identify these individuals. We should identify gender minority individuals and report this data in medical records in order to build much needed epidemiological information.

The effect of polysomnography on pediatric adenotonsillectomy postoperative management

2005 ◽  
Vol 132 (2) ◽  
pp. 263-270 ◽  
Author(s):  
Anthony A. Rieder ◽  
Valerie Flanary
Keyword(s):  
Length Of Stay ◽  
Airway Obstruction ◽  
Complication Rate ◽  
Chart Review ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Postoperative Management ◽  
Postoperative Course

OBJECTIVE: We retrospectively investigated the effect and predictability of preoperative polysomnography (PSG) on the postoperative course of younger pediatric patients undergoing adenotonsillectomy. STUDY DESIGN AND SETTING: A retrospective chart review was performed for patients 3 years of age and younger who had undergone adenotonsillectomy between July 1997 and July 2002 at the Children's Hospital of Wisconsin. RESULTS: Two hundred eighty-two patients were identified. Forty-three patients had preoperative PSG. No correlation between the severity of PSG results and postoperative course was identified. CONCLUSIONS: The role of PSG in upper airway obstruction and OSA remains controversial. This study suggests that although the complication rate may be higher in this younger population, these complications do not appear to have a large impact on their length of stay. SIGNIFICANCE: This study suggests that the 3-years-and-younger group, in the absence of other comorbidities, can safely undergo adenotonsillectomy without undergoing preoperative PSG. EBM raing: C.

Trading Osteoplasty for Osteotomy in an Attempt to Achieve a Rapid Recovery Rhinoplasty

2021 ◽  
pp. 074880682199142
Author(s):  
Dominick J. Gadaleta ◽  
Anna Frants ◽  
Benjamin C. Paul ◽  
David Rosenberg
Keyword(s):  
Recovery Time ◽  
Chart Review ◽  
Revision Rate ◽  
Nasal Bone ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Rapid Recovery ◽  
Critical Component ◽  
Periorbital Region

Nasal bone lateral osteotomies are a critical component of open and closed rhinoplasty. Lateral osteotomies represent the most traumatic component of rhinoplasty and contribute to significant edema and ecchymosis in the periorbital region. We believe that lateral osteotomies are often performed more frequently than necessary. The senior author of this article has significantly decreased the number of lateral osteotomies that he performs during rhinoplasty and instead advocates for the use of osteoplasty with a rasp when appropriate to narrow and shape the bony dorsum without forming a wide flat open-roof deformity. This study is a retrospective chart review of 239 patients who underwent rhinoplasty with the senior author. Almost half of the patients (44%) did not undergo osteotomies. The revision rate is less than 1% (2 patients). Avoidance of lateral osteotomies in carefully selected patients can offer a more appealing “rapid recovery rhino,” which is characterized by decreased edema, swelling, and faster recovery time with less limitations on postoperative restrictions.

Multilevel Esophageal Biopsy in Children with Airway Manifestations of Extraesophageal Reflux Disease

2007 ◽  
Vol 116 (8) ◽  
pp. 571-575 ◽  
Author(s):  
Ron Mitzner ◽  
Linda Brodsky
Keyword(s):  
Reflux Disease ◽  
Chart Review ◽  
Tertiary Care ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Extraesophageal Reflux ◽  
Esophageal Biopsy ◽  
Additional Information ◽  
Airway Symptoms

Objectives: Extraesophageal reflux disease (EERD) is a recognized cause of upper airway symptoms in children. Direct microlaryngoscopy and bronchoscopy (MLB) is performed for diagnostic information as to the extent and severity of the inflammation caused by gastric refluxate. Esophagoscopy with multilevel biopsy performed at the time of MLB may provide the clinician with additional information to assist in the management of EERD. We undertook to determine the role of multilevel esophageal biopsy in children who have airway manifestations secondary to EERD. Methods: We performed a retrospective chart review of 139 esophagoscopies with multilevel biopsy done at the time of MLB by a single provider for evaluation of symptoms highly associated with EERD at a tertiary care children's hospital. The histopathologic presence of esophagitis was analyzed by site and compared to the presence and location of tracheolaryngeal abnormalities. Results: Tracheolaryngeal abnormalities associated with EERD were found in 97% of patients when evaluated by MLB. Concomitant esophagitis was found in 59% of these patients. Of patients who had 0, 1, 2, 3, 4, or 5 positive findings on MLB, 75% (3 of 4), 58% (7 of 12), 57% (20 of 35), 62% (32 of 51), 56% (18 of 32), and 80% (4 of 5), respectively, had at least 1 positive biopsy. Conclusions: We found that EERD that affects the pediatric upper airway was associated with esophagitis in more than half of the patients. The usefulness of 4-level biopsies during esophagoscopy and concomitant airway endoscopy will be discussed.

scholarly journals 0987 Characterizing Scratch And Limb Movements In Atopic Dermatitis During Sleep

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A375-A375
Author(s):  
G M Gillow ◽  
C Robins ◽  
R Palomo ◽  
S S Sheldon ◽  
A B Fishbein
Keyword(s):  
Atopic Dermatitis ◽  
Chart Review ◽  
Sleep Stage ◽  
Retrospective Chart Review ◽  
Movement Analysis ◽  
Sleep Stages ◽  
Limb Movements ◽  
Video Footage ◽  
And Gender ◽  
Future Work

Abstract Introduction Children with atopic dermatitis (AD) experience significant sleep disruption due to nocturnal scratching. Our group has found distinct patterns of limb movements in contrast to control and PLMD patients. To expand on previous findings, our objective was to characterize timing and duration of scratch v. non-scratch movement in children with AD coincidentally undergoing polysomnography (PSG). Methods Retrospective chart review of PSG, video footage was synchronized with the EEG and limb electrode readings using a time/date generator and was then operationally classified as either scratching or non-scratching movement. Analysis of data was done using SPSS and groups were compared using an ANOVA. Results We analyzed four previously completed sleep studies in children with atopic dermatitis (1 female and 3 males), mean age years±SD 11.3±1.0, mean BMI±SD 21.9±7.1, mean AHI±SD 2.3±0.8. Average scratch duration was not significantly different by sleep stage, N1v.N2v.N3v.REM (mean scratch duration in seconds±SD= 9.0±1.5 v 6.3±3.2 v. 11.9±11.8 v. 6.3±7.3, respectively p=0.65). However, frequency of scratching events were more common during N2v.N1v.N3v.REM (mean scratching events±SD= 9.3±3.9 v 3.8±1.7 v. 4.3±4.3 v. 1.3±1.9, respectively p=0.02). Yet, given the duration of total time spent in sleep stages, minutes of scratching events occupied the largest percentage of N1v.N2v.N3v.REM (mean% ±SD= 3.9±0.9 v. 0.6±0.4 v. 0.4±0.2 v. 0.3±0.5, respectively, p&lt0.01). Interestingly, non-scratch related movements were not significantly different between sleep stages (p=0.2). However, non-scratch related movements trended to occupy the largest percentage of N1v.N2v.N3v.REM (mean% ±SD= 9.3±7.7 v. 2.1±1.6 v. 1.5±0.8 v. 1.9±1.4, respectively, p=0.05). Conclusion Our results suggest that scratching episodes in children with AD occur most commonly during N2 sleep, but occupy the largest % of N1 sleep. Future work will include comparing these limb movements to age and gender-matched allergic rhinitis patients. Support This study was unfunded.

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