A5023383631- Head and Neck Surgical Oncology
- Salivary Gland Tumors Diagnosis and Treatment
- Pituitary Gland Disorders and Treatments
- Cancer, Hypoxia, and Metabolism
- Meningioma and schwannoma management
- Oral and Maxillofacial Pathology
- Nasal Surgery and Airway Studies
- Cancer, Lipids, and Metabolism
- Ear and Head Tumors
- Facial Nerve Paralysis Treatment and Research
- Tumors and Oncological Cases
- Surgical Simulation and Training
- Reconstructive Surgery and Microvascular Techniques
- Head and Neck Cancer Studies
- Thyroid Cancer Diagnosis and Treatment
- Reconstructive Facial Surgery Techniques
- Anesthesia and Sedative Agents
- Trigeminal Neuralgia and Treatments
- Facial Trauma and Fracture Management
- Sinusitis and nasal conditions
- Myasthenia Gravis and Thymoma
- Airway Management and Intubation Techniques
- Anesthesia and Pain Management
- Facial Rejuvenation and Surgery Techniques
- Glutathione Transferases and Polymorphisms
Thomas Jefferson University Hospital
2016-2023
Thomas Jefferson University
2016-2022
Commonwealth Medical College
2015
Objective The tumor microenvironment frequently displays abnormal cellular metabolism, which contributes to aggressive behavior. Metformin inhibits mitochondrial oxidative phosphorylation, altering metabolism. Though the mechanism is unclear, epidemiologic studies show an association between metformin use and improved outcomes in head neck squamous cell carcinoma (HNSCC). We sought determine if alters metabolism apoptosis HNSCC tumors. Study Design Window of opportunity trial diagnostic...
Objective Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence risk factors for NOF after exenteration. Study Design Retrospective chart review, systematic meta-analysis. Setting Tertiary care center. Participants Patients undergoing free flap reconstruction following Records were reviewed clinicopathologic data, operative details, outcomes. Main Outcome Measures Univariate...
Adenoid cystic carcinoma (ACC) is a relatively rare tumor of epithelial cell origin, most commonly arising from major salivary glands. It uncommonly found outside the or minor glands and especially when located in nasal cavity. Diagnosis treatment ACC pose numerous challenges, partly due to its biological behavior slow growth, high tendency local recurrence, perineural invasion. We present case 67-year-old male with complaints facial pain swelling, CT scan showing soft tissue mass extending...
To assess risk factors for cerebrospinal fluid (CSF) leak and complications after microvascular reconstruction of cranio-orbitofacial resection with orbital exenteration (CFOE).Retrospective case series.Seventy consecutive patients at a tertiary hospital underwent 76 procedures CFOE defects. Patients were stratified by extent skull base exposure presence or absence dural resection. the apex roof alone classified as minimal (MS) (n = 32). Those beyond significant (SS) 38) subdivided into...
Objective In many cancers, including head and neck squamous cell carcinoma (HNSCC), different regions within a tumor have metabolic phenotypes. Transfer of metabolites between compartments promotes growth aggressive behavior. Metabolic compartmentalization in HNSCC nodal metastases has not been studied, nor its impact on extracapsular extension or clinical outcomes determined. Study Design Retrospective analysis based immunohistochemistry staining. Setting Tertiary care center. Subjects...
This case presentation examines a rare clinical entity: colorectal adenocarcinoma (CRC) metastasis to the tongue. CRC is among least common tumors metastasize oral cavity. Objectives for this report are (1) maintain high index of suspicion cavity representing metastatic disease, (2) consider appropriate surgical and adjunctive interventions, (3) recognize significance identifying primary tumor via immunohistochemical staining. We present 57-year-old male with history stage IV rectal lung who...
Abstract Objectives Pain and analgesic requirements after functional endoscopic sinus surgery (FESS) vary widely. This study aims to quantify pain routine FESS determine the most commonly used management regimen. Methods Retrospective chart review of 100 patients who underwent from Oct 2017 May 2019. Patients prospectively completed a daily diary reported levels that were categorized into no (0), mild (1‐3), moderate (4‐7), or severe (8‐10). narcotics, non‐narcotics, combination, none based...
Introduction: As dedicated endoscopy suites for skull base surgery are becoming more prevalent, it is important to consider the optimal operative room setup. Multiple techniques have been presented surgeon positioning two-team endoscopic surgery. Classically, neurosurgeon and otolaryngologist stand adjacent each other on same side of patient bed while operating. We describe an alternative approach utilizing dynamic where two surgeons across from other. discuss merits this both a...
Introduction: Large cranial base defects after transsphenoidal surgery exposes the brain to iatrogenic injury via insertion of endonasal tubes. It has reported in literature that nasogastric tubes (NGT) have inadvertently been placed into stem or spinal cord postoperatively. This can devastating ramifications including neurologic sequelae and patients died secondary intracranial NGT placement. For these reasons, it is prudent implement surgical techniques help protect against endoscopic,...
Background: Extensive craniofacial resections may require orbital exenteration, which carries a risk of cerebrospinal fluid (CSF) leak.
Introduction: The pedicled nasoseptal flap (NSF) is the mainstay for closure after endoscopic anterior cranial base surgery. NSF not necessary repair of all skull defects as CSF leaks are always encountered intra-operatively like in case pituitary However, preservation important it may be required future use. We present an update to Jefferson Approach that includes five approaches protect one or both pedicles while allowing adequate exposure tumor resection.
Background: The treatment of facial nerve synkinesis remains complex and variable. Objective: To compare oral, palpebral fissure, brow symmetry among surgical nonsurgical interventions in patients with synkinesis. Methods: Patients at a single tertiary care center between 2008 2022 were analyzed before after using Emotrics software. Symmetry was compared combination groups (chemodenervation rehabilitation [CR] vs. chemodenervation surgery [CS] chemodenervation, surgery, [CSR]) intervention...
Background: With the advent of more advanced imaging modalities and its widespread use, pituitary incidentalomas (PI) are increasingly being detected at a higher rate than before when patients worked up for nonpituitary–related conditions. Criteria surgical nonsurgical management this clinical entity now clearly delineated previously. This study analyzes our institution's robust experience in operative PIs over 14-year period, making it largest cohort literature.
Background: Malignant tumors of the nasal cavity and paranasal sinuses have potential to invade into surrounding structures including orbit skull base. The orbital periosteum has long been considered a barrier spread such can be regarded as decisive layer when determining extent tumor resection. However, interpretation invasion become extremely challenging difficult visualize separately from bony wall on imaging.
This study was approved by the Thomas Jefferson University Institutional Review Board.Retrospective identification of patients who underwent rhinoplasty with inferior turbinate reduction at a single academic institution between January 2017 and December 2020 completed.Data collected included demographics, risk factors, intraoperative techniques, postoperative clinical course.Each patient completed one two ways: surgeon utilized submucous resection technique, second performed partial excision...
Introduction With the global COVID-19 pandemic, nasopharyngeal swabbing has become commonplace and can occasionally cause discomfort, tearing, anxiety. Objective To evaluate whether using a neural distraction device during mitigate patient discomfort. Methods Participants were randomized into nasal swab with vibration first (treatment-control or Tc) without (control-treatment Ct). Then was repeated opposite technique. The used to stimulate infraorbital nerve at midpupillary line, while...
Reconstruction after parotidectomy can include fat grafting, which allows for symmetry, but grafts have demonstrated volume loss over time.To provide quantitative evidence the rate of grafts.Patients who received with graft reconstruction at a single institution from August 2016 to October 2020 were identified. Relationships between clinical factors and logarithmic analyzed.Twelve patients parotidectomy, reconstruction, underwent postoperative magnetic resonance imaging (MRI) scan. Rate was...