Publications by authors named "Boris Paskhover"

88 Publications

Adverse Events Associated with Intranasal Sprays: An Analysis of the Food and Drug Administration Database and Literature Review.

Ann Otol Rhinol Laryngol 2021 Apr 3:34894211007222. Epub 2021 Apr 3.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Background: Intranasal sprays (INSs) are commonly used medications for the treatment of many rhinologic conditions. Despite their popularity, an analysis of a nationwide reporting database and comparison to the available literature has never been performed.

Methods: The Food and Drug Administration Adverse Event Reporting System (FAERS) database was accessed to obtain adverse event (AE) records from 2014 to 2019 for varying INSs, including: 10 corticosteroids, 1 alpha adrenergic, and 3 antihistamines. The Proportional Reporting Ratios (PRR) and Reporting Odds Ratios (ROR) were calculated for dyspnea, anosmia, ageusia/dysgeusia, epistaxis, and headache. A PRR ≥ 2 or ROR ≥ 1 was considered significant.

Results: Corticosteroids had 98 864 total reported AEs to the database, followed by antihistamines (7011) and alpha adrenergics (2071). In total, dyspnea was reported 5843 times, followed by headache (4230), epistaxis (1205), ageusia/dysgeusia (920), and anosmia (312). Overall, PRR and ROR values for dyspnea ranged from 0.51 to 4.25 and 0.51 to 4.49; for dysgeusia/ageusia from 0.56 to 6.09 and 0.56 to 6.12; and for epistaxis from 1.03 to 27.24 and 1.03 to 30.76, respectively. All medications which listed anosmia within the top AEs had PRR and ROR values exceeding 2 and 1, respectively. The PRR for headache exceeded 2 for 1 medication and the ROR exceeded 1 in 7 medications.

Conclusion: The AEs of dyspnea, anosmia, ageusia/dysgeusia, epistaxis, and headache are reported within the FAERS database for commonly prescribed INSs. When compared against the existing scientific literature, the clinical significance of this reporting tool from the FDA for these classes of medications remains unvalidated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/00034894211007222DOI Listing
April 2021

Evaluating YouTube as a Resource for Trigeminal Neuralgia Patient Education.

J Oral Maxillofac Surg 2021 Feb 20. Epub 2021 Feb 20.

Assistant Professor, Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.

Purpose: The objective of this study was to examine the educational value of YouTube as a source of patient information regarding trigeminal neuralgia and its treatment. We also sought to determine the degree of bias that is present in the top videos regarding this condition.

Materials And Methods: We selected 6 search terms related to trigeminal neuralgia to examine on YouTube for quality and bias using the DISCERN criteria. Filtering by relevance and total view count, we determined the top 20 results for each search term and evaluated all videos for overall educational quality and creator bias. We categorized the type of content creator and compared overall DISCERN scores and bias scores between creator type and search term.

Results: There were 80 unique and 40 duplicate videos. There were 10,745,574 total views across all videos, with an average view count of 89,546. The mean DISCERN score for all videos was 1.7, and the mean bias score was 2.2. Based on individual search terms, the highest mean DISCERN score was for trigeminal neuralgia surgery (2.1) and the highest mean bias score was for tic douloureux (2.8). Among creator types, medical professionals had significantly higher overall (2.2) and bias (2.6) scores.

Conclusions: Overall, YouTube is a relatively poor source of unbiased information about trigeminal neuralgia. Among the existing content, medical professionals provide educational material that is the highest quality and the most unbiased.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2021.02.013DOI Listing
February 2021

YouTube as a Patient Education Resource for Male Hypogonadism and Testosterone Therapy.

Sex Med 2021 Apr 19;9(2):100324. Epub 2021 Mar 19.

Division of Urology, Department of Surgery, Rutgers-New Jersey Medical School, Newark NJ, USA; Department of Urology, Hackensack UMC-Meridian Health, Hackensack NJ, USA. Electronic address:

Introduction: YouTube is an unregulated platform that patients are using to learn about treatment options.

Aim: To assess the reliability of YouTube videos (YTVs) related to male hypogonadism and testosterone therapy.

Methods: Searching on YouTube by relevance and view count, we analyzed the top 10 videos (80 videos total) for the following search terms: low testosterone, testosterone replacement therapy, AndroGel, and hypogonadism.

Main Outcome Measure: We recorded the number of views for each video, evaluated videos using the DISCERN score (DS) criterion, and compared the DS for videos including board-certified physicians and videos without. A second comparison was made between videos with board-certified physicians in urology, endocrinology, other MD, and those without any physician.

Results: The YTVs analyzed received a total of 38,549,090 views, a median of 25,201 and 17.30 views/day. Videos that featured physicians had significantly fewer views/day than videos that did not (39.48 CI 9,72 vs 1,731 CI 330, 3,132; P = .019). Most YTVs studied were unreliable. The median DS across all videos was 2. However, most videos created by physicians were found to be reliable with a median DS of 4. In addition, YTVs that did not feature a physician were found to be significantly less reliable than videos that featured a physician (3.22 CI 3.06, 4.09 vs 1.87 CI 1.56, 2.18; P < .001). There was no significant difference in the reliability or viewership of YTVs stratified by physician type.

Conclusion: Most YTVs related to male hypogonadism/testosterone therapy were unreliable, but there are reliable YTVs available. Reliable videos usually feature a physician and receive fewer views than unreliable YTVs. Physicians and academic societies should work to provide verified videos to provide patients with reliable information about male hypogonadism and testosterone therapy. CJ Warren, J Wisener, B Ward, et al. YouTube as a Patient Education Resource for Male Hypogonadism and Testosterone Therapy. Sex Med 2021;9:100324.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.esxm.2021.100324DOI Listing
April 2021

Characterizing Patient Questions Before and After Rhinoplasty on Social Media: A Big Data Approach.

Aesthetic Plast Surg 2021 Mar 15. Epub 2021 Mar 15.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA.

Background: As an aesthetic surgery, a successful rhinoplasty is often assessed by patient satisfaction, subject to a diverse array of qualitative factors including patient expectations and happiness with care provided. While substantial effort has been dedicated to understanding patients' post-operative concerns, addressing patients' pre-operative questions has been comparatively less studied. This study analysed pre- and post-operative questions about rhinoplasty on social media to gain insights into patients' concerns and develop targeted educational material.

Methods: The most viewed rhinoplasty questions on Realself.com, a social media platform for discussions about cosmetic surgeries, were collected and analysed. Questions were then stratified into pre- and post-operative and further assigned categories based on common topics found in the data. Using a machine learning approach, the most common pre- and post-operative questions were determined.

Results: 2014 rhinoplasty questions were collected in total, with 957 pre-operative and 1057 post-operative. The most commonly asked pre-operative questions were about appearance (n = 441, 46.1%), function (n = 102, 10.7%), and cost (n = 94, 9.8%). The most commonly asked post-operative questions were about appearance (n = 502, 47.5%), behaviour allowed/disallowed (n = 283, 26.8%), and symptoms after surgery (n = 235, 22.2%). An educational handout with the 10 most common pre- and post-operative questions was developed using machine learning analysis, with the majority of questions about appearance.

Conclusions: Patients primarily expressed concern about appearance when asking questions about rhinoplasty on social media, along with other aspects of their pre- and post-operative course. The educational handout developed by this study can be applied to address commonly asked patient questions during pre-operative education.

Level Of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-021-02203-9DOI Listing
March 2021

Septic Arthritis of the Temporomandibular Joint: A Systematic Review.

J Oral Maxillofac Surg 2021 Jan 14. Epub 2021 Jan 14.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ; and Assistant Professor, Facial Plastics & Reconstructive Surgery.

Purpose: The purpose of this study was to describe the characteristics of the patient history, clinical findings, laboratory tests, treatment, and long-term function of septic arthritis of the temporomandibular joint (SATMJ).

Methods: All articles in the English literature related to SATMJ were queried using PubMed, Embase, and the Cochrane Library (1950 to July 1, 2020). The reference lists were reviewed for additional articles.

Results: A preliminary search of the literature returned 241 results, of which 37 met inclusion criteria, with an additional article from reference review. There were 93 total cases, with a mean age of 35.7 years (0.1 to 85). Symptoms mostly consisted of pain in the temporomandibular joint/preauricular region (n = 84, 90.3%), trismus (n = 73, 78.5%), and facial/preauricular swelling (n = 68, 73.1%). Most patients had no systemic symptoms (n = 80, 86.1%). The mean degree of mouth opening was 13.1 mm (5 to 35). Diagnosis was made with the following imaging modalities: radiograph (n = 48, 51.6%), CT scan (n = 35, 37.6%), MRI (n = 25, 26.9%), and ultrasound (n = 3, 3.2%). Staphylococcus aureus (n = 19, 20.4%) was most commonly isolated. About 92 patients (98.9%) received antibiotics and 85 patients underwent surgery (eg, arthrocentesis, arthroscopy, etc.), of which 15 patients (17.6%) required repeat surgery. Most long-term outcomes were favorable. Sequelae occurred in 26 of 85 patients (30.6%) with documented follow-up.

Conclusions: SATMJ should be suspected in the presence of trismus, jaw pain, and preauricular swelling. Management includes prompt evaluation and treatment with broad-spectrum antibiotics. Surgery is not always indicated but can be life-saving in severe cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2021.01.004DOI Listing
January 2021

Re: Metabolic syndrome and postoperative thyroidectomy outcomes.

Head Neck 2021 Feb 26. Epub 2021 Feb 26.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hed.26651DOI Listing
February 2021

An Updated Look at Television-Related Pediatric Head and Neck Injuries: Safer Products and a Shifting Paradigm.

J Craniofac Surg 2021 Feb 18. Epub 2021 Feb 18.

Rutgers New Jersey Medical School Department of Otolaryngology, New Jersey Medical School, Newark, NJ.

Abstract: Television tip-over injuries have been designated a top-five hidden home hazard by the United States Consumer Product Safety Commission. In this study the authors utilize the National Electronic Injury Surveillance System (NEISS) Database to provide an updated look at television-related head and neck injuries in the United States pediatric population. The NEISS Database was accessed for all television-related head and neck injury reports from January 2000 to December 2018 in patients under 18 years of age. Demographic data including age, sex, and race were also obtained. Narrative descriptions of each injury were also individually reviewed and categorized by specific type of injury. Miscoded reports were excluded. Between January 2000 and December 2018, 5944 NEISS reports of television-related injuries met inclusion criteria, corresponding to an estimated total of 159,785 injuries nationally during this period. The average patient age at time of evaluation was 4.11 years with a male predominance of 61.3%. Total number of injuries - and weighted national estimates - remained relatively stable between 2000 and 2006, peaking in 2009 (450 reported cases, 12,004 estimated national total). Between 2009 and 2018 the number of reported injuries, and corresponding national estimates, saw a 75.8% and a 72.1% decrease, respectively. Television-related head and neck injuries have declined dramatically in the United States since 2009. The underlying cause of this decline is likely multifactorial, and additional steps to improve the safety of these products are necessary to continue to ensure the safety of all children in the United States.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000007547DOI Listing
February 2021

Quality, Reliability, and Readability of Online Information on Rhinoplasty.

J Craniofac Surg 2021 Jan 28. Epub 2021 Jan 28.

Department of Otolaryngology-Head and Neck Surgery Department of Facial Plastics and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark, NJ.

Background: With an ever-growing reliance on technology, patients are increasingly resorting to websites for their medical information. This study evaluates the readability, quality, and reliability of online information available on rhinoplasty provided by academic centers or impartial reference sources and private practice websites.

Methods: A cross-sectional study from July to August 2019 was performed looking at the first 42 informational websites on a Google search for the term nose job. Websites were categorized as belonging to impartial sources and academic centers or private practices. Two independent reviewers evaluated websites on their quality, readability, reliability, and technical qualities using several validated measures. The Health on the Net code (HONcode) and DISCERN questionnaire were used to assess the quality and reliability of the information presented on the websites. Significance tests were performed using SPSS Version 25.

Results: Of the 42 websites, 23 were impartial sources or academic centers (54.8%) and 19 were private practice websites (47.6%). The mean (±SD) for the HONcode and DISCERN scores were 5.7 (±2.8) and 2.6 (±0.7), respectively. The mean (SD) HONcode scores for impartial sources and private practice websites were 7.1 (±2.9) and 4.1 (±1.5), respectively (P < 0.001). The mean (±SD) DISCERN scores were 2.9 (±0.7) and 2.3 (±0.5), respectively (P = 0.009). There was no statistically significant difference in scores for readability and technical qualities.

Conclusions: While impartial sources and academic centers score higher on quality and reliability scores, their scores were also low. These findings are concerning as many consumers use the information provided by online websites to guide decisions regarding their health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000007487DOI Listing
January 2021

Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes.

Head Neck 2021 Apr 28;43(4):1271-1279. Epub 2020 Dec 28.

Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Objective: Metabolic syndrome (MetS) has previously been linked to increased risk of postoperative morbidity and mortality in other surgical undertakings. Because MetS is a consequence of endocrine dysfunction, and given the thyroid's crucial role in endocrine homeostasis, we sought to evaluate the association between MetS and postoperative outcomes of thyroidectomy.

Methods: Data were acquired from the ACS-NSQIP database from years 2005 to 2017. Patients with obesity, diabetes, and hypertension were defined as having MetS. Odds ratios (OR) were obtained for outcomes to quantify risk with multivariate logistic regression.

Results: Outcomes significantly affected by MetS included overall complication (OR: 2.00), extended postoperative stay (OR: 1.52), medical complication (OR: 1.48), surgical complication (OR: 1.62), and mortality (OR: 2.33).

Conclusions: Patients with MetS undergoing thyroidectomy are at increased risk of an increased length of stay, overall complications, and mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hed.26588DOI Listing
April 2021

Molecular mechanisms of trigeminal neuralgia: A systematic review.

Clin Neurol Neurosurg 2021 Jan 5;200:106397. Epub 2020 Dec 5.

NYU Grossman School of Medicine, Department of Neurosurgery, New York, NY, USA. Electronic address:

Objective: To conduct a systematic review of the available literature for primary research articles identifying potential gene mutations, polymorphisms and other molecular regulatory mechanisms related to trigeminal neuralgia in order to identify the genetic and molecular models of primary trigeminal neuralgia currently being investigated.

Methods: PubMed and Web of Science were systematically searched to identify primary research articles discussing genetic predictors of trigeminal neuralgia and neuropathic pain that were published prior to July 2020. This review was conducted according to PRISMA guidelines.

Results: Out of the 333 articles originally identified, a total of 14 papers were selected for study inclusion. These articles included 5 human studies, 6 mouse studies and 3 rat studies. Four articles investigated sodium channels, 1 investigated a sodium channel and nerve growth factor receptor, 2 investigated potassium channels, 1 investigated calcium channels, 1 investigated the downstream regulatory element antagonist modulator protein, 1 investigated the dynorphin-kappa opioid receptor system, 1 investigated TRPA1, 1 investigated the Nrg1/ErbB3/ErbB2 signaling complex, 1 investigated a serotonin transporter and 1 investigated potassium channels, sodium channels, calcium channels, chloride channels, TRP channels and gap junctions.

Conclusion: Researchers have identified multiple genetic and molecular targets involved with potential pathophysiologies that have a relationship to the creation of trigeminal neuralgia. At this time, there does not seem to be clear causal frontrunner, demonstrating the possibility that genetic predisposition to trigeminal neuralgia may involve multiple genes and/or downstream products, such as ion channels.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2020.106397DOI Listing
January 2021

The Aging Parotid Gland: A Longitudinal Volumetric Study and Implications for Treatment.

Aesthet Surg J 2021 03;41(4):408-414

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Background: The parotid gland accounts for significant soft tissue volume in the face and is therefore of central relevance to facial and neck rejuvenation.

Objectives: The aim of this study was to determine how parotid gland volume is predicted by age and other factors.

Methods: We conducted a retrospective longitudinal study of patients with multiple computed tomography (CT) scans of the neck performed at least 7 years apart. Parotid gland volumes were measured and multiple linear regression analysis was performed to model the relations between age, body mass index (BMI), and parotid volume.

Results: The study cohort comprised 70 patients. The mean [standard deviation] ages at initial and final imaging time points were 47.5 [12.6] and 58.8 [12.2] years, respectively, with an average of 11.3 years elapsed between CT scans. The mean parotid gland volume increased from 28.7 [10.0] to 32.2 [10.7] mL over the average 11.3-year period (P = 0.03). However, the results of the multiple linear regression analysis show that when controlling for BMI and sex, age alone does not predict parotid volume (P = 0.29). BMI was directly correlated with gland volume (P < 0.01). An increase of 1.0 kg/m2 in BMI predicted an increase in parotid volume by 1.1 mL. Male sex was also associated with significantly greater parotid volume.

Conclusions: Mean parotid volume increased over time but these gains were driven by increases in BMI and not age alone. These findings are highly relevant to the treatment of the aging face and neck.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/asj/sjaa361DOI Listing
March 2021

Can You Trust What You Watch? An Assessment of the Quality of Information in Aesthetic Surgery Videos on YouTube.

Plast Reconstr Surg 2020 12;146(6):824e

Division of Plastic and Reconstructive Surgery, Rutgers-New Jersey Medical School, Newark, N.J.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PRS.0000000000007404DOI Listing
December 2020

Adverse Events Associated With Botox as Reported in a Food and Drug Administration Database.

Aesthetic Plast Surg 2020 Oct 30. Epub 2020 Oct 30.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Background: Botulinum toxin treatment is the most frequently performed noninvasive cosmetic procedure performed in the USA. Because of its widespread use, an analysis of the adverse event (AE) profile of Botox injections is needed.

Methods: The FDA Adverse Event Report System was queried using an online web-based tool to determine the top 15 adverse events reported for four Botox brand names: Botox/Botox Cosmetic, Dysport, and Xeomin. The proportional reporting ratios (PRR) and relative odds ratios (ROR) were determined. A literature review was performed for eight AEs of clinical significance: eyelid/eyebrow ptosis, asthenia, muscular weakness, facial paresis, dysphagia, botulism, and death.

Results: Botox/Botox Cosmetic had 38367 AEs. Dysport had 3582 AEs. Xeomin had 1405 AEs. All drugs with reported cases of eyelid and eyebrow ptosis had significant PRR and ROR values. The PRR and ROR values for asthenia were not significant in any of the drugs and only reached significance for Dysport for muscular weakness and dysphagia. Both Botox/Botox Cosmetic and Dysport had elevated PRRs and RORs for facial paresis and botulism. While all drugs had at least one reported case of death related to Botox injection use, none of the PRR or ROR values were significant.

Conclusion: Known AEs for Botox injection use include eyelid/brow ptosis and muscular weakness. Feared but rare complications of Botox injection use include dysphagia, botulism, and possibly death, owing to systemic spread of the toxin. This is the first study to analyze the AE data reported to the FDA on Botox injection use.

Ebm Level: III.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-020-02027-zDOI Listing
October 2020

The Submandibular Gland and The Aging Neck: A Longitudinal Volumetric Study.

Aesthetic Plast Surg 2020 Oct 20. Epub 2020 Oct 20.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Introduction: The true effect of aging and other patient factors on submandibular gland (SMG) volume is unclear. We sought to evaluate the effects of age, body mass index (BMI), sex and race on SMG volume using computed tomography (CT) imaging.

Methods: We conducted a retrospective longitudinal study of adult subjects with multiple CT images of the neck at least 7 years apart. Subjects with history of salivary gland pathology, neck dissection, head and neck radiation, active infection or dental artifact were excluded. Three-dimensional volumes were measured. Age, BMI, sex and race data were analyzed to track their longitudinal effect on SMG volume.

Results: The study comprised 64 patients (Females n=36; Males n=28) with mean age of 47.1 and 58.5 at each respective time point (mean difference 11.4). Mean SMG volume increased from 10.1 ml to 10.5 ml (P < 0.05). Males had significantly greater SMG volume compared to females. Majority of growth occurred in the < 40 year age bracket (0.1 ml/year), more significantly in the male cohort. When controlling for aging and sex, a change in BMI was the only patient factor that predicted a change in SMG volume. An increase of 1.0 kg/m predicted a 0.17 ml increase in gland volume. Race had no significant effect.

Conclusion: Our findings suggest that the majority of SMG volume change occurs in early adulthood ( < 40 years), especially in males. Among the factors we studied, a change in BMI was the only significant predictor of SMG volume change.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 . Genital Surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-020-02009-1DOI Listing
October 2020

Vocal Fold Immobility Following Vaccination.

Ann Otol Rhinol Laryngol 2020 Oct 16:3489420965633. Epub 2020 Oct 16.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Objective: Vocal fold immobility (VFI) may severely affect quality of life due to dysphonia and respiratory distress. Many etiologies of this disorder have been evaluated, however the relationship between VFI and vaccination has yet to be explored. The objective of this study was to identify the relationship between VFI and vaccine administration.

Methods: The Vaccine Adverse Event Reporting System (VAERS) database was queried for patients exhibiting symptoms of VFI following vaccination. Patient demographics and clinical information including presenting symptoms, time of symptom onset, laterality, outcomes, and adverse events were documented.

Results: Twenty-two patients were found to have VFI following vaccination. Of those reported, 13 patients were female (59.1%) and 8 were male (36.4%) with an average age of 48.4 years. Vaccinations for influenza, shingles, pneumococcus, and hepatitis B were reported. A majority of these cases were unilateral in nature (73.3%). Mean lag time from vaccination to symptom onset was 6.3 days (range 0-45 days). Five adverse events were reported, with 4 patients requiring intubation and tracheostomy.

Conclusion: Vaccine administration may be associated with VFI and physicians should be cognizant of this potential adverse event. This is a rare complication with less reported cases than other post-vaccination cranial neuropathies. The difficulty in establishing an initial diagnosis and need for specialized evaluation by an otolaryngologist may result in under-reporting of such events. Further research is needed to delineate the exact pathophysiology of this complication and determine whether a causal relationship exists.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489420965633DOI Listing
October 2020

Anatomic Danger Zones of the Head and Neck.

Dermatol Surg 2020 12;46(12):1549-1559

William W. Bruce, MD, Distinguished Chair, Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska.

Background: Dermatologic procedures require a detailed understanding of surface anatomy to avoid complications. The head and neck region has prominent danger zones including nerves and vasculature that may be at risk during cutaneous surgery. A thorough understanding of these danger zones can help avoid complications that may lead to functional or cosmetic impairment.

Methods: The anatomic literature regarding the course of high-risk structures of the head and neck was reviewed. Structures deemed at risk during dermatologic procedures were included in the analysis. The final analysis focused on branches of the facial nerve, parotid duct, spinal accessory nerve, trigeminal nerve, and the lacrimal system. Anatomical information was compiled regarding each high-risk structure to develop a "danger zone" at which each respective structure is at risk.

Results: The danger zone for each structure was compiled based on the review of the literature and depicted in the figures.

Conclusion: With careful attention to anatomy and the meticulous surgical technique, there is great potential for reduction in surgical injury to danger zones of the head and neck.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DSS.0000000000002603DOI Listing
December 2020

Orthopaedic Injuries Associated With Cell Phone Use Resulting in Emergency Department Visits: A 20-year Analysis.

J Am Acad Orthop Surg 2020 Sep 17. Epub 2020 Sep 17.

From the Weill Cornell Medical College, New York, NY (Moore), Yale School of Medicine, New Haven, CT (Halperin, Berson, Burroughs), Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, NJ (Paskhover), and Yale Department of Orthopaedics and Rehabilitation, New Haven, CT (Grauer).

Introduction: Cell phones are an integral part of daily life but are distractors that can contribute to injury. The present study uses a large national emergency department (ED) database to evaluate the frequency, anatomic location, and type of injuries associated with cell phone use. We hypothesize that orthopaedic injuries related to cell phone use have increased over time and affect certain body parts and age groups more than others.

Methods: The 1999 to 2018 Nation Electronic Injury Surveillance System was queried for cell phone-related injuries leading to ED visits (injuries to the head or face or involving a landline were excluded). Demographics, type of orthopaedic injury, and body part injured were tabulated, and injuries were then classified over time as direct mechanical or cell phone use-associated, as well as related to texting compared with talking.

Results: A weighted national total of 44,599 injuries met inclusion criteria. A marked increase was noted in the incidence of cell phone use-associated injuries over the time (2,900%). Injuries occurred in persons with mean ± standard deviation age of 36.6 ± 19.9 years old, predominantly in women (60.6%), at home (32.8%) or on the street (22.4%), and while walking (31.6%) or driving (18.16%). The distribution of orthopaedic injuries was defined and occurred most frequently in the neck, lower torso/hip, and ankle. The most common types of injuries were sprain/strain (56.8%) and fracture (32.6%). The proportion of fracture injury types was significantly greater in adults aged greater than 65 (P < 0.001). The proportion of injuries related to texting on a cell phone was greatest in the 13- to 29-year-old age group and declined as age increased.

Discussion: Orthopaedic injures related to cell phone use resulting in ED visits have markedly increased over time. The distribution and characteristics of such injuries can be used in targeted public health education and policy development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5435/JAAOS-D-20-00639DOI Listing
September 2020

Analysis of Head and Neck Primary Cutaneous Mucinous Carcinoma: An Indolent Tumor of the Eccrine Sweat Glands.

J Craniofac Surg 2020 Sep 1. Epub 2020 Sep 1.

Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, NJ.

Background/objectives: Primary cutaneous mucinous carcinoma (PCMC) of the head and neck is a rare pathologic entity that is an adenocarcinoma of the eccrine sweat glands. Though it has low metastatic potential, it does have a significant recurrence rate. Due to its rarity, its clinical features are not well-known.

Methods: The authors searched the National Cancer Database (NCDB) for all cases of PCMC with primary sites of the skin of the head and neck confirmed histologically diagnosed from 2004 to 2016. Those with missing survival information were excluded. Kaplan-Meier (KM) and Cox proportional-hazards models were used to analyze the epidemiology and survival outcomes of PCMC.

Results: The authors analyzed 289 cases. Females were more commonly affected (58.8%; P < 0.05) with the most common primary sites being the eyelid (41.9%) and scalp/neck (25.3%). The average age of diagnosis was 63.8 years (± SD 12.5). Almost all patients received surgery as standalone treatment (92.7%) with wide local excision being the common surgery performed (36.3%). Mohs surgery represented 15.2% of surgically treated cases. Mean overall survival (OS) was 11.4 years with 5-year and 10-year OS being 85.0% and 78.0%, respectively. Most cases were localized at diagnosis with only 2% metastatic at presentation. KM analysis indicated that surgical procedure type, age, tumor diameter, Charlson-Deyo Comorbidity Score, facility type, and stage were significant predictors of OS (P < 0.05). Cox proportional-hazards analysis did not reveal independent association of the aforementioned factors with OS.

Conclusion: Primary cutaneous mucinous carcinoma has an excellent prognosis with 98% of cases being diagnosed in Stage I and Stage II. As most cases present in the eyelid, special attention should be given to surgical treatment to ensure optimal aesthetic outcomes in this sensitive region. This study represents the largest cohort of head and neck PCMC studied to date.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000006968DOI Listing
September 2020

The Benefit of Primary Tumor Surgical Resection in Distant Metastatic Carcinomas of the Thyroid.

Laryngoscope 2021 May 31;131(5):1026-1034. Epub 2020 Aug 31.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Objectives/hypothesis: Thyroid cancer with distant metastasis (TCDM) at diagnosis has significantly worse survival rates when compared to localized/regional thyroid cancer. This study sought to report on the characteristics of patients presenting with TCDM and the potential survival advantage of surgical resection.

Study Design: Data were acquired from the Surveillance, Epidemiology, and End Results (SEER) database with cases from 2004 to 2015.

Methods: TCDM cases (n = 2,558) were identified from the SEER database. The Bonferroni correction was applied for multivariate analysis. Kaplan-Meier analysis was utilized to obtain disease-specific survival (DSS) rates. Cox regression analysis was utilized to identify independent factors significantly associated with survival.

Results: The average age of diagnosis of TCDM was 62.0 (±17.5) years. Patients were predominantly white (74.6%), female (54.6%), in a relationship (56.0%), and between ages 36 and 80 years (76.4%). Cases consisted of papillary (57.2%), follicular (16.0%), medullary (8.9%), anaplastic (17.9%) TCDM histological variants. Overall 1-, 5-, and 10-year DSS rates were 72.0%, 56.8%, and 43.8%, respectively. Anaplastic and medullary variants had the worst 10-year DSS (0% and 25.5%, respectively). Patients who underwent surgical resection only and surgical resection with radiation were 49% and 59% less likely to die, respectively. Treatment, age, histology, T staging, relationship status, and metastasis site were determined to be significant predictors of survival.

Conclusions: Surgical resection with radiation was found to be a significant predictor of survival after applying the Bonferroni correction for all thyroid cancer variants except medullary. To increase survival, surgical intervention should be recommended in patients who are deemed to be medically tolerant of surgery.

Level Of Evidence: 4 Laryngoscope, 131:1026-1034, 2021.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/lary.29053DOI Listing
May 2021

A Google Trends Analysis of Facial Plastic Surgery Interest During the COVID-19 Pandemic.

Aesthetic Plast Surg 2020 08 5;44(4):1378-1380. Epub 2020 Aug 5.

Department of Otolaryngology Head and Neck Surgery, Rutgers - New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA.

The COVID-19 pandemic has had a multitude of effects on daily life. Aesthetic and cosmetic surgery practices have been significantly reduced in their working capacity or closed during this time. We used Google Trends to gauge the public's interest in facial plastic surgery during this pandemic, and how it has changed over the preceding months. As local shelter-in-place orders are being lifted, interest in facial plastic surgery is increasing even in the context of an ongoing national pandemic. LEVEL OF EVIDENCE V: Letter to the Editor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-020-01903-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406132PMC
August 2020

Implications of Change to USMLE Step 1 Scoring for Otolaryngology Residency Programs.

Otolaryngol Head Neck Surg 2020 Nov 7;163(5):855-856. Epub 2020 Jul 7.

Department of Otolaryngology-Head & Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.

Otolaryngology is a competitive specialty, with 398 US seniors applying to an offered 328 positions in 2019. Recent changes to US Medical Licensing Exam (USMLE) Step 1 scoring raise many questions for both medical student applicants and program directors. Otolaryngologists are known to be collegial and thoughtful physicians. Focusing on other nonstandardized testing scores may help the specialty "reboot" and refocus on recruiting the best people, not just applicants with a high Step 1 score and Alpha Omega Alpha (AOA) status.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0194599820936631DOI Listing
November 2020

Reporting of Research by Matched Otolaryngology Residency Applicants.

Ann Otol Rhinol Laryngol 2021 Feb 4;130(2):133-135. Epub 2020 Jul 4.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Rutgers-New Jersey Medical School, Newark, NJ, USA.

Objectives: Matching to an otolaryngology residency program is a competitive process for medical students, and research performed by students is considered as a factor for granting interviews by program directors. Because abstracts, presentations and publications are all reported in combination by the National Resident Matching Program's "Charting Outcomes in the Match" (ChOM) and may be weighted differently by PDs, we specifically investigated the number of publications by past applicants accepted to top otolaryngology residency programs.

Methods: The top 25 otolaryngology residency programs were identified using Doximity, sorting by reputation. Current residents were determined from the programs' websites. Using PubMed, each resident's number of publications, authorship status, and journal type were recorded.

Results: A total of 24 programs were included in the final analysis and the average number of manuscripts was 2.76 ± 4.01. The mean number of publications in otolaryngology journals was 1.03 ± 1.91.

Conclusions: The difference between the investigated average number of publications (2.76) and those published by ChOM (10.4) represent a discrepancy due to the lack of delineation between abstracts, presentations and publications. The reported numbers for research may lead medical students to pursue alternate measures to increase their own research. Some options, such as adding a research year are not universally accessible. A clearer and more detailed approach to reporting research statistics would be beneficial to both applicants and PDs for otolaryngology programs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489420938821DOI Listing
February 2021

Response to "Impact of Online Sources and Social Media on Plastic Surgery in China".

Aesthet Surg J 2020 08;40(9):NP584

Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/asj/sjaa160DOI Listing
August 2020

Analysis of Characteristics and Survival of Primary Cutaneous Adenoid Cystic Carcinoma of the Head and Neck.

Ann Otol Rhinol Laryngol 2021 Jan 21;130(1):12-17. Epub 2020 Jun 21.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Background/objectives: Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare skin tumor. The head and neck (H&N) is the most common anatomical location. Due to limited published cases, its clinical course and management are not well understood.

Methods: The National Cancer Database (NCDB) was queried for all cases of H&N PCACC diagnosed from 2004 to 2016. Kaplan-Meier (KM) and Cox proportional hazards models were used to determine clinicopathological and treatment factors associated with survival outcomes.

Results: A total of 201 cases were analyzed. The average age of diagnosis was 57.7 years (± SD 15.8). There was a female predilection (57.7%;  < .05) with the most common primary site being the ear (58.2%). The average tumor size was 15.9 mm in diameter. The most common treatment was surgery alone (51.7%) with wide local excision being the common surgery performed (36.3%). 5-year and 10-year OS were 87.0% and 76.0%, respectively. A total of 65.8% of cases were localized (Stage I and II). KM analysis indicated that gender, age, insurance status, Charlson-Deyo Comobordity Score, and stage were significant predictors of OS ( < .05). Cox proportional hazards analysis revealed that patients with both private (HR 0.11, 95%CI [0.019-0.670];  = .02) and government (HR 0.12, 95%CI [0.019-0.972];  = .03) health insurance had a significantly decreased hazard of death than patients who were uninsured. Increasing age was associated with an increased hazard of death (HR 1.06, 95%CI [1.016-1.110];  = .01).

Conclusion: This study represents the largest cohort of H&N PCACC studied to date and provides important clinicopathologic information for this rare tumor. Additionally, our results emphasize the importance of health insurance as an independent predictor of survival in PCACC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489420936719DOI Listing
January 2021

Why Otolaryngologists Get Excluded From Medicare and Medicaid.

Ear Nose Throat J 2020 Jun 10:145561320933040. Epub 2020 Jun 10.

Department of Otolaryngology-Rutgers New Jersey Medical School, Newark, NJ, USA.

The List of Excluded Individuals and Entities (LEIE) is a federally updated and available list of providers who have been excluded from participating from federal healthcare programs. With over 40 year's worth of exclusion history, we were able to isolate and identify otolaryngologists who were excluded and the most common cause, albeit exceptionally rare, was revocation of their medical license due to negligence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0145561320933040DOI Listing
June 2020

From the Deep-Plane Rhytidectomy to the Vertical Platysma Advancement.

Facial Plast Surg Clin North Am 2020 Aug 6;28(3):311-330. Epub 2020 May 6.

Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, NJ, USA; Section of Facial Plastics and Reconstructive Surgery, Department of Otolaryngology, St. Barnabas Medical Center-RWJ Health, Livingston, NJ, USA.

This article provides the facial plastic surgeon with anatomic and embryologic evidence supporting use of the deep-plane technique and understanding the evolution of the technique over decades to the vertical platysma advancement for optimal treatment of facial aging. The original description of the deep-plane rhytidectomy described a basic subsuperficial musculoaponeurotic system dissection in the midface. This plane of dissection provides access to deeper anatomic structures. A detailed description of the procedure is provided to allow safe and consistent performance. Insights into anatomic landmarks, technical nuances, and alternative approaches for facial variations are presented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.fsc.2020.03.002DOI Listing
August 2020

The Utilization of YouTube as a Resource on Hair Loss Treatments.

Aesthetic Plast Surg 2020 10 3;44(5):1944-1946. Epub 2020 Jun 3.

Department of Otolaryngology, Rutgers New Jersey Medical School, 90 Bergen St, Newark, NJ, 07101, USA.

Introduction: To the best of our knowledge, no previous studies have evaluated the quality of videos discussing hair loss treatments METHODS: YouTube was searched on December 10, 2019, using the relevance and view count filters for the following search terms: hair loss treatment, baldness, alopecia, male pattern baldness, and female pattern baldness. The DISCERN criterion for assessing consumer health information was used to evaluate each video. A score of 1 indicates a low overall video quality, whereas a 5 indicates a high-quality source of information for patients. The DISCERN treatment assessment is a validated tool to assess the quality of patient information about treatment choices. Two-sample t tests and Mann-Whitney U tests were used to determine significance.

Results: We analyzed 90 videos receiving a total of 108,240,496 views with a mean view count of 1,202,672 views per video (Table 1). Pharmaceuticals including minoxidil and finasteride were the most commonly mentioned treatment (30% of videos) followed by nutraceuticals (20%). YouTube influencers (Table 2) represented 37.8% of authors followed by companies/advertisers (15.6%). Seventeen videos (18.9%) included board-certified dermatologists. The mean DS overall was 2.66, and the mean DS for bias was 2.98.

Discussion: Our data demonstrate the extensive use of YouTube for hair loss treatment information. While YouTube can be a valuable resource for patients, videos are often biased and can misinform patients. Moreover, the lack of a central review process or governing body to validate claims made in videos can be a safety concern.

Ebm Level V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-020-01797-wDOI Listing
October 2020

Opinion: An Increase in Severe, Late Dental Complications Might Result From Reliance on Home Dental Remedies During the COVID-19 Pandemic.

J Oral Maxillofac Surg 2020 Aug 15;78(8):1232-1233. Epub 2020 May 15.

Assistant Professor, Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2020.05.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227514PMC
August 2020

Neuromodulation of the lingual nerve: a novel technique.

J Neurosurg 2020 Apr 24:1-5. Epub 2020 Apr 24.

2Rutgers New Jersey Medical School, Newark, New Jersey.

Acute injury of the trigeminal nerve or its branches can result in posttraumatic trigeminal neuropathy (PTTN). Affected patients suffer from chronic debilitating symptoms long after they have recovered from the inciting trauma. Symptoms vary but usually consist of paresthesia, allodynia, dysesthesia, hyperalgesia, or a combination of these symptoms. PTTN of the trigeminal nerve can result from a variety of traumas, including iatrogenic injury from various dental and maxillofacial procedures. Treatments include medications, pulsed radiofrequency modulation, and microsurgical repair. Although trigeminal nerve stimulation has been reported for trigeminal neuropathy, V3 implantation is often avoided because of an elevated migration risk secondary to mandibular motion, and lingual nerve implantation has not been documented. Here, the authors report on a patient who suffered from refractory PTTN despite multiple alternative treatments. He elected to undergo novel placement of a lingual nerve stimulator for neuromodulation therapy. To the best of the authors' knowledge, this is the first documented case of lingual nerve stimulator implantation for lingual neuropathy, a technique for potentially reducing the risk of electrode migration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3171/2020.2.JNS193109DOI Listing
April 2020

Liposomal Bupivacaine in Rhinoplasty: An Underused Tool.

J Oral Maxillofac Surg 2020 08 13;78(8):1239-1240. Epub 2020 Mar 13.

Assistant Professor, Division Chief of Facial Plastics & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2020.02.031DOI Listing
August 2020