A5067462488- Reconstructive Surgery and Microvascular Techniques
- Reconstructive Facial Surgery Techniques
- Tracheal and airway disorders
- Head and Neck Cancer Studies
- Head and Neck Surgical Oncology
- Trauma Management and Diagnosis
- Facial Nerve Paralysis Treatment and Research
- Nerve Injury and Rehabilitation
- Salivary Gland Tumors Diagnosis and Treatment
- Airway Management and Intubation Techniques
- Bone fractures and treatments
- Vascular Procedures and Complications
- Facial Trauma and Fracture Management
- Cancer Diagnosis and Treatment
- Cleft Lip and Palate Research
- Head and Neck Anomalies
- Orthopedic Surgery and Rehabilitation
- Voice and Speech Disorders
- Meningioma and schwannoma management
- Dysphagia Assessment and Management
- Ear and Head Tumors
- Thyroid and Parathyroid Surgery
- Venous Thromboembolism Diagnosis and Management
- Esophageal and GI Pathology
- Hemostasis and retained surgical items
Oregon Health & Science University
2016-2025
VA Portland Health Care System
2024
University of Portland
2023-2024
Portland VA Medical Center
2024
University of California, San Francisco
2024
University of Oklahoma
2022
The University of Texas MD Anderson Cancer Center
2020
Arkansas Department of Agriculture
2020
John Wiley & Sons (United States)
2020
Hudson Institute
2020
To present an updated version of the original Facial Nerve Grading Scale (FNGS), commonly referred to as House-Brackmann scale.Controlled trial grading systems using a series 21 videos individuals with varying degrees facial paralysis.The intraobserver and interobserver agreement was high among revised scales. Nominal improvement is seen in percentage exact grade reduction instances examiners differing by more then one when FNGS 2.0. 2.0 also offers improved differentiating between grades 3...
No consensus exists as to the best technique, or techniques, optimize wound healing, decrease pharyngocutaneous fistula formation, and shorten both hospital length of stay time initiation oral intake after salvage laryngectomy. We sought combine recent experience multiple high-volume institutions, with different reconstructive preferences, in management pharyngeal closure technique for post-radiation therapy total laryngectomy an effort bring clarity this clinical challenge.To determine if...
Objectives/Hypothesis Document a 15‐year experience with 29 cases of acute invasive fungal rhinosinusitis (AIFR) and evaluate factors predictive disease clearance overall survival. Study Design Case series chart review. Methods Patients were identified by review department billing records between 1995 2010. Medical reviewed for patient demographics, characteristics, clinical course including surgical medical therapy, treatment outcomes, long‐term Results Twenty‐nine patients AIFR identified....
<h3>Importance</h3> Sarcopenia, or the loss of muscle mass, is associated with poor treatment outcomes in a variety surgical fields. However, association between sarcopenia and long-term survival broad cohort patients head neck cancer (HNC) unknown. <h3>Objective</h3> To determine whether undergoing major surgery for HNC. <h3>Design, Setting, Participants</h3> A retrospective medical records review was conducted at tertiary care academic hospital. Two hundred sixty ablative procedures...
Optimal postoperative pain management is challenging. Virtual reality (VR) provides immersive, 3-dimensional experiences that may improve control and reduce reliance on pharmacologic management.To evaluate use of VR after head neck surgery.This prospective, pilot randomized clinical trial was conducted at Oregon Health & Science University from July 2020 to October 2021 included patients hospitalized major surgery.Similar 15-minute interactive gaming (Angry Birds) using an Oculus Quest...
Objective To examine implementation of virtual reality (VR) and Fitbit wearable activity devices in postoperative recovery. Methods This was a prospective, 4‐arm, randomized controlled trial patients undergoing inpatient head neck surgery at tertiary academic center from November 2021 to July 2022. Patients were Control, VR, Fitbit, or combined VR + groups. the groups brought headsets use throughout each day, wore encouraged achieve 2,000 daily steps. The primary outcome average opioid use,...
Background: Speech and swallowing dysfunctions are common following the anterior approach to cervical spine.Despite functional morbidity legal implications, incidence etiologic factors of these complications have not been adequately elucidated.Objective: To better define speech dysfunction both in quantitative qualitative sense.Methods: A questionnaire was mailed 497 patients who had undergone fusion or discectomy at a university hospital (study group).One hundred fifty questionnaires were...
The incidence of cerebrospinal fluid (CSF) leak following trans-sphenoidal surgery ranges from 0.5% to 15.0%. Factors predicting which patients are likely develop postoperative leaks and optimal management these poorly defined. objective was determine 1) the CSF surgery; 2) demographic or intraoperative factors associated with leaks; 3) techniques efficacy at Oregon Health Science University, (Portland, OR).Retrospective chart review.Two hundred thirty-five surgeries were performed on 216...
Although increasingly accepted in treatment of the N0 neck, use selective neck dissection patients with node-positive squamous cell carcinoma head and remains controversial.To determine oncologic efficacy node neck.Three tertiary care academic/Veterans Affairs medical centers.Ten-year retrospective chart review 106 previously untreated clinically pathologically undergoing 129 dissections followed for a minimum 2 years or until patient death.Regional metastasis was staged as N1 58 (54.7%),...
OBJECTIVES Treatment of severe epistaxis can encompass many modalities. Control rates with all treatments are good. Morbidity among treatment groups varies. Angiographic embolization is one such method that has a very low complication rate. Over the last 10 years, it become preferred at our institution. STUDY DESIGN Tertiary medical referral centers: OHSU, Portland VAMC. MATERIALS AND METHODS Retrospective review 70 patients transferred or admitted posterior and treated selective...
Objective Examine if outcomes and complication rates for free flaps vary when postoperative aspirin is used as pharmacologic thromboprophylaxis compared with no anticoagulation. Study Design Case series chart review. Setting Oregon Health Science University, an academic medical center. Subjects Methods A case review was performed using a prospectively maintained microvascular reconstructive database to identify cases of tissue transfer between February 2006 April 2010. Outcome variables...
<h3>Importance</h3> Postoperative wound complications after total laryngectomy (TL) increase hospital stay, costs, and delay adjuvant therapy when indicated. Recently, sarcopenia has been identified as a predictor of postoperative in patients undergoing major surgery but not assessed head neck patients. <h3>Objective</h3> To determine the incidence with squamous cell carcinoma (SCC) TL evaluate its association development complications. <h3>Design, Setting, Participants</h3> Retrospective...
Free tissue transfer has success rates greater than 95%. Approximately 10% will require reexploration for vascular compromise. Return to the operating room within 48 hours yields highest rate of successful salvage. Our aim was determine whether an implantable Doppler used intraoperative/postoperative monitoring would 1) alter pattern detecting flap failure and 2) overall incidence survival.Prospective analysis.Generic study specific data collected. Note made at end case if revision...
Venous thromboembolism (VTE) is associated with significant morbidity and mortality in surgery patients, but little data exist on the incidence of VTE head neck cancer surgical patients.To determine postoperative patients cancer.A prospective study 100 consecutive hospitalized at a tertiary care academic center who underwent to treat cancer. Routine chemoprophylaxis was not used. On day (POD) 2 or 3, participants received clinical examination duplex ultrasonographic evaluation (US)....
Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience meticulous technique, there a small but recognized risk partial or total loss in postoperative setting. Historically, microvascular surgeons involve resident house staff monitoring protocols, programs relied heavily on in-house physicians assure timely intervention for compromised flaps. In 2003, Accreditation Council Graduate Medical Education...
Data regarding outcomes after major head and neck ablation reconstruction in the growing geriatric population (specifically ≥80 years of age) are limited. Such information would be extremely valuable preoperative discussions with elderly patients about their surgical risks expected functional outcomes.To identify patient factors associated 30-day postoperative complications, 90-day mortality, decline; to explore whether an association exists between type reconstructive procedure outcome;...
Background Actinomycotic infections of the cervicofacial region are uncommon. Most major medical centers report approximately one case per year. Presenting clinical manifestations confusing because they often mimic other disease processes. Diagnosis may be difficult due to a general lack familiarity with and fastidious nature organism in culture. The actinomycosis varied, high index suspicion is required make an accurate timely diagnosis. Methods Retrospective chart review presentation four...
Management of patients with cerebrospinal fluid rhinorrhea (CSF) remains controversial. Most studies recommend either an endoscopic or external extracranial approach, depending on the surgeon's preference. Eighteen CSF have been managed at our institution since 1990. The causes consisted functional sinus surgery (7), lateral rhinotomy excision a benign nasal tumor (3), spontaneous and secondary repair after intranasal ethmoidectomy (1). In 11 leak was recognized time surgery; in 10 these it...
Advanced-stage oropharyngeal cancer may be treated either surgically or nonsurgically. We reported previously functional outcomes after surgical resection with free-tissue transfer. In the present study, we evaluated swallowing function combined chemoradiation for cancer.Retrospective review of 30 patients at a tertiary academic center Stage III/IV sequential concurrent from 1994 to 2003.Inclusion criteria were met by 27 (90%) patients. Most had base tongue lesions (67%) and IV disease...
The presence of cervical lymph node metastasis in patients with head and neck cancer is associated an unfavorable prognosis. Reports vary as to whether various conventional radiographic studies, such computed tomography (CT) magnetic resonance imaging, confer advantage over physical examination the patient without clinical findings (N0). Positron emission (PET) a functional imaging modality that has recently been used for neoplasms. use PET evaluation N0-staged 14 consecutive squamous cell...
Schwannomas are benign, slow-growing tumors that arise from nerves. Those originating the sympathetic cervical chain rare. We describe our experience with clinical presentation, surgical management, and outcomes of patients this pathology.Retrospective chart review a case series in tertiary referral center.Four cases schwannomas were reviewed. Patients presented either an asymptomatic neck mass discovered on routine physical examination (1 patient), enlarging (2), or acute onset Horner's...
Abstract Background. Free‐tissue transfer has become the preferred method of head and neck reconstruction but is a technique that considered to use excessive hospital resources. Methods. This study retrospective review 125 consecutive free flaps in 117 patients over 16‐month period at tertiary care university hospital. Results. Defects oral cavity/oropharynx (60%), midface (9%), hypopharynx (15%), or cervical facial skin (16%) were reconstructed from three donor sites: forearm (70%), rectus...