A5070758847- Sinusitis and nasal conditions
- Nasal Surgery and Airway Studies
- Head and Neck Surgical Oncology
- Allergic Rhinitis and Sensitization
- Olfactory and Sensory Function Studies
- Patient Satisfaction in Healthcare
- Tracheal and airway disorders
- Surgical Simulation and Training
- Anatomy and Medical Technology
- Mycobacterium research and diagnosis
- Vascular Anomalies and Treatments
- Hearing, Cochlea, Tinnitus, Genetics
- Otitis Media and Relapsing Polychondritis
- Dental Research and COVID-19
- Simulation-Based Education in Healthcare
- Sleep and related disorders
- Sleep and Work-Related Fatigue
- Pathogenesis and Treatment of Hiccups
- Cell death mechanisms and regulation
- Infection Control and Ventilation
- Cervical Cancer and HPV Research
- Otolaryngology and Infectious Diseases
- Sharing Economy and Platforms
- Genital Health and Disease
- Patient-Provider Communication in Healthcare
University of Toronto
2003-2020
Royal Victoria Regional Health Centre
2013-2016
Toronto Sleep Institute
2013
Northwestern Memorial Hospital
2011-2012
Northwestern University
2011-2012
Hospital for Sick Children
2007-2009
SickKids Foundation
2009
Heart and Stroke Foundation
2003
Intractable epistaxis is a common otolaryngology emergency. Transnasal endoscopic sphenopalatine artery ligation (TESPAL) and endovascular arterial embolization both provide excellent success rates, therefore the decision to choose one over other can be challenging.To aid in making by evaluating cost-effectiveness of TESPAL vs for intractable epistaxis.Economic evaluation using tree model with 14-day time horizon emergency department consultations patients defined as persistent bleeding...
There is increasing evidence that both cell adhesion molecules and soluble factors are involved in tumor metastasis. We have found endothelial cells secrete chemoattractants can induce melanoma chemotaxis. Protein separation on an ion-exchange column shows the association of IL-8 with fractions contain chemoattractant activity. This activity completely lost from conditioned medium after immunoprecipitation anti-IL-8 antibodies, indicating major secreted by cells. IL-877, predominant isoform...
Abstract Objectives/Hypothesis: To assess the safety and surgical technique of bilateral simultaneous cochlear implantation in children. Study Design: Prospective case series at a tertiary academic pediatric hospital. Methods: Surgical times, complications, patient outcomes are reported from first 50 consecutive implants performed Hospital for Sick Children between 2005 2008. These results were compared to same measures group sequentially implanted children consecutively 2001 Results: The...
To assess whether improvements in pulmonary function and microbial pathogenic findings can be achieved by endoscopic sinus surgery a pediatric population with cystic fibrosis.Retrospective medical record review.Academic research.Forty-one patients fibrosis who had undergone at single tertiary academic otolaryngology practice.Changes test values or respiratory tract pathogens after were examined.Endoscopic did not improve results this population. Examination of colonization showed that affect...
Background It is universally accepted that osteomeatal complex (OMC) disease linked to the subsequent development of chronic rhinosinusitis without nasal polyps (CRSsNPs) via postobstructive mechanisms. The role OMC obstruction in pathogenesis CRSwNPs less clear. This study was designed identify if there an association between and inflammation adjacent sinuses, when patients are stratified by polyp status. a follow-up expanded series previous pilot from our group. Method CT scans 144 with...
Objectives/Hypothesis To diagnose chronic rhinosinusitis (CRS), current guidelines require either endoscopic or computed tomography (CT) findings of sinus disease. a primary care physician, this means referral to an otolaryngologist obtaining CT scan. Unfortunately, the sensitivity endoscopy for detecting CRS is low, and examination by Otolaryngologist may not yield definitive diagnosis. This leaves scanning. However, contradicted recommendations limit scanning only preoperative planning...
Abstract Background: Surgical training models are being increasingly used to provide an environment for surgical trainees improve their skills without risk patients. This study uses previously validated, inexpensive, low‐fidelity determine how pretraining affects endoscopic sinus surgery (ESS) skills. Methods: Fourteen Otolaryngology residents were randomized 1 of 2 groups that stratified level. The first group took part in a session where they practiced on all 5 different modules whereas...
Current treatment algorithms for patients with symptoms of chronic rhinosinusitis (CRS) recommend a trial empiric medical therapy prior to obtaining sinus computed tomography (CT) scan, even in cases negative nasal endoscopy. This approach evolved an era when same day conventional CT was both impractical and economically irresponsible. The objective this work determine whether upfront scanning is more cost-beneficial than presenting CRS but endoscopic findings.A Markov economic model...
Background Before a simulator becomes widely accepted, it must be relevant, affordable, and accessible. We have developed low-cost model emphasizing the basic skills required for endoscopic sinus surgery (ESS). It is noninvasive, free from risk of infection, an excellent low-pressure learning opportunity. The current study was designed to assess construct validity our simulator. Methods conducted stratified randomized crossover-control study. Otolaryngology residents, fellows, faculty...
Current symptom criteria poorly predict a diagnosis of chronic rhinosinusitis (CRS) resulting in excessive treatment patients with presumed CRS. The objective this study was analyze the positive predictive value individual symptoms, or symptoms combination, CRS and examine costs subsequent diagnostic algorithm using decision tree-based cost analysis.We analyzed previously collected patient-reported from cross-sectional who had received computed tomography (CT) scan their sinuses at tertiary...
For patients with epistaxis in whom initial interventions, such as anterior packing and cauterization, had failed, options including prolonged posterior packing, transnasal endoscopic sphenopalatine artery ligation (TESPAL), embolization are available. However, it is unclear which interventions should be attempted order. While cost-effectiveness analyses have suggested that TESPAL the most responsible use of health care resources, physicians must also consider patient risk to maintain a...
A previous effort to identify the threshold for surgery in recurrent acute rhinosinsutis (RARS) was made based on workforce productivity. While this macroeconomic approach is useful population-level decision making, patient-level making variable and driven by personal financial implications. This microeconomic study seeks levels of infection where becomes worthwhile patients costs, lost income, quality life.Cost-Benefit Breakeven Analysis.A breakeven analysis constructed from literature...
Long term taste dysfunction after otologic surgery has never been characterized in children. The aim of this study is to determine the rates gustatory normal and postotologic children.Cross-sectional study.One hundred sixty children visiting a tertiary pediatric otolaryngology clinic, 4 18 years age, were recruited. Surgical groups included patients who had undergone tympanoplasty, combined approach mastoidectomy, modified radical unilateral bilateral cochlear implantation. They then tested...
Objective Treatment of recurrent acute rhinosinusitis (RARS) has 2 effective modalities: medical therapy with exacerbations or surgery to reduce the frequency and severity infections. However, it is unclear when one should be recommended over other. This study seeks identify a threshold number infections where morbidity offset by RARS. Study Design Health economic breakeven analysis. Setting Clinical otolaryngology practice. Subjects None. Methods A model productivity was constructed...
Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset end of 2019. Amongst most impacted are elective medical and surgical order to conserve resources care for COVID-19 patients. As number infected patients decrease across Canada, surgeries being restarted a staged manner. Since Otolaryngologists - Head & Neck Surgeons manage diseases upper aerodigestive tract where highest viral load reside, it is imperative...
Chronic rhinosinusitis (CRS) is a prevalent chronic inflammatory disease. The basis of clinical diagnosis CRS for primary care physicians (PCPs) based upon the recognition symptom constellation that manifests with However, because symptomatology may overlap other diagnoses, referral patient to most appropriate specialist not always occur, leading further delays in evaluation and treatment.Given emphasis on improving value health Canada, decision tree model was designed evaluate whether an...
Objectives Oral corticosteroid (OCS) as a part of appropriate medical therapy (AMT) (formerly maximal therapy) in chronic rhinosinusitis remains controversial. While the risks OCS are well known, benefit unclear due absence standardized prescribing regimen. Consequently, it is difficult to characterize whether and its ability avert endoscopic sinus surgery (ESS) helpful AMT. When highly effective at averting surgery, lesser would be justified because can avoid greater ESS. poorly ESS, not...
Objective The management of recurrent acute bacterial rhinosinusitis (RARS) remains a controversial subject. Distinguishing RARS from viral upper respiratory infection (URI) is difficult, and when to consider surgery unclear. This study seeks identify threshold number infections where the benefit balances lost productivity RARS. Method An economic model was constructed using literature‐reported medical surgical response rates, as well measures quality life productivity. data utilized...