Publications by authors named "Corina Din-Lovinescu"

10 Publications

  • Page 1 of 1

Adverse events following injection laryngoplasty: An analysis of the MAUDE database.

Am J Otolaryngol 2021 May 27;42(6):103092. Epub 2021 May 27.

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

Objective: Injection laryngoplasty (IL) is considered safe in both the operating room and clinical setting. However, safety data is limited to single-institution studies with reduced sample sizes. The objective of this study is to examine a national database for adverse events related to IL in an effort to further confirm the safety of this procedure and better characterize potential complications.

Materials And Methods: Retrospective analysis of the Manufacturer and User Facility Device Experience (MAUDE) database for reported adverse events of IL procedures utilizing calcium hydroxyapatite (CAHA), hyaluronic acid (HA) and carboxymethylcellulose (CMC) implants from 2009 to 2020.

Results And Analysis: We identified 47 reported adverse events. The average patient age was 54 years old. 59.3% of patients were female. Adverse events more frequently involved the use of CAHA compared to HA or CMC (n = 27, 57.4%, n = 13, 27.7% and n = 7, 14.9%, respectively). The most common adverse events were laryngeal edema (n = 18, 39.1%), improper placement of injected material (n = 12, 26.1%), persistent dysphonia (n = 13, 28.3%), and post-injection dysphagia or odynophagia (n = 11, 23.9%). Major events, defined as requiring emergency room treatment, hospitalization, or surgical intervention accounted for 29 (60.4%) of cases. Four cases of edema required intubation, and one patient necessitated a surgical airway.

Conclusion: Complications arising from IL range from minor events to airway obstruction and may happen with a variety of injectable materials including CAHA, HA and CMC. Few cases of airway obstruction requiring immediate intervention were identified, confirming the safety of IL in both the operative and office setting.
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http://dx.doi.org/10.1016/j.amjoto.2021.103092DOI Listing
May 2021

Impact of preoperative dehydration on endoscopic transsphenoidal pituitary surgery.

Int Forum Allergy Rhinol 2021 Feb 4. Epub 2021 Feb 4.

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

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http://dx.doi.org/10.1002/alr.22767DOI Listing
February 2021

Vocal Fold Immobility Following Vaccination.

Ann Otol Rhinol Laryngol 2021 Jun 16;130(6):609-613. 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.
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http://dx.doi.org/10.1177/0003489420965633DOI Listing
June 2021

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures.

Ann Otol Rhinol Laryngol 2021 Mar 4;130(3):245-253. Epub 2020 Jul 4.

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

Objective(s): Negative pressure pulmonary edema (NPPE) is a rare perioperative complication with a potentially fatal outcome. The aim of this study was to perform a systematic review of NPPE in adult otolaryngology procedures with the goal of identifying risk factors, clinical presentation, diagnosis, management and outcomes.

Methods: Systematic review performed using PubMed, Scopus, Web of Science, and Cochrane databases.

Results: Sixty-nine studies including data from 87 individual patients were included in this review. Fifty-six (68%) patients were male and the average patient age was 37 years old. Type 1 NPPE occurred in 63 (72%) cases, while type 2 NPPE accounted for 20 (23%) cases. The most common procedures leading to NPPE were septoplasty, rhinoplasty or sinus surgery (n = 22, 25%), directly laryngoscopy or bronchoscopy (n = 13, 15%), and tracheostomy or cricothyroidotomy (n = 11, 13%). The most employed treatment options included diuretics (n = 55, 63%) and mechanical ventilation (n = 54, 62%). Seventy-eight (90%) patients made a full recovery with an average time to NPPE resolution of 33 hours and an average length of hospitalization of 5.6 days. Five (6%) patients had a long-term morbidity and four (5%) patients died, with age and ICU stay increasing risk for death and long-term morbidity (OR 1.044 and 7.42, respectively,  < .05).

Conclusion: Septoplasty, rhinoplasty and sinus surgery account for the majority of NPPE cases in adult otolaryngology procedures. Young, healthy patients are the most commonly involved with a slight male predominance. The vast majority of patients recover fully, however there is a significant risk for morbidity and mortality.
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http://dx.doi.org/10.1177/0003489420938817DOI Listing
March 2021

Intracranial complications of pediatric rhinosinusitis: Identifying risk factors and interventions affecting length of hospitalization.

Int J Pediatr Otorhinolaryngol 2020 Apr 19;131:109841. Epub 2019 Dec 19.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology-Head and Neck Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA.

Objective: To identify risk factors and interventions affecting length of hospitalization (LOH) and clinical outcome in children with intracranial complications of rhinosinusitis.

Methods: Retrospective chart review of 12 children hospitalized at 2 academic medical centers for intracranial complications of rhinosinusitis over the past 5 years.

Results: 12 patients were identified with an average age at presentation of 13 years old. 92% were male and 75% were African American. The most common presenting symptoms were fever and headache. Localizing neurological symptoms including hemiparesis and aphasia, in addition to seizures occurred in 33% of patients and increased LOH significantly (33 versus 15 days, p = 0.03). Epidural (EA) and subdural abscesses (SA) were the most common intracranial complications. 58% of patients were initially treated with a combination of open neurosurgical (ON) intervention and endoscopic sinus surgery (ESS) and LOH was significantly shorter for these patients compared to those treated otherwise (14 versus 31 days, p = 0.02). Streptococcus species were the most common group of bacteria identified in 75% of cases, with S. anginosus accounting for 42% of cases. The overall average LOH was 21 days with 92% of patients having complete resolution of symptoms by time of discharge.

Conclusions: Treatment of intracranial complications of acute rhinosinusitis can have favorable outcomes after appropriate surgical management. Localizing neurologic symptoms and seizures portend longer hospital stay and recovery time. Shorter hospital stay was seen in those undergoing early combined ON and ESS interventions.
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http://dx.doi.org/10.1016/j.ijporl.2019.109841DOI Listing
April 2020

How Have Craniofacial Injuries Changed in Adult Bicyclists Over the Past 10 Years?

J Oral Maxillofac Surg 2020 Feb 14;78(2):254.e1-254.e8. Epub 2019 Aug 14.

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

Purpose: As bicycling popularity grows in the United States, it becomes increasingly important to understand and characterize bicycle-related injuries. In this study, we sought to characterize craniofacial injuries in adult cyclists and to evaluate trends in injuries over the past 10 years.

Materials And Methods: In this retrospective cohort study, the National Electronic Injury Surveillance System was queried for bicycle-related craniofacial injuries in adults aged 18 to 64 years from January 1, 2008, to December 31, 2017. Variables examined included demographic characteristics, diagnosis, patient disposition, and change in number of injuries and age-adjusted incidence of injuries from 2008 to 2017. Linear regression analysis was performed to evaluate trends in injuries over time, with statistical significance set at P < .05.

Results: There were an estimated 573,305 visits to emergency departments across the United States for bicycle-related craniofacial injuries from 2008 to 2017. Male patients (75%), patients aged 18 to 24 years (25%), and white patients (54%) were injured most commonly. The population-adjusted incidence of total injuries increased by 22% from 2008 to 2017 (P = .13). The rates of traumatic brain injury and craniofacial fractures rose by 50% (P = .06) and 63% (P  < .01), respectively. Cyclists aged 55 to 64 years had the highest increase in the age-adjusted incidence of injury from 2008 to 2017, by 54% (P < .01).

Conclusions: Bicycle-related trauma remains a public health concern, with a steady number of craniofacial injuries presenting to emergency departments across the United States during the past 10 years. Injuries have increased for adults aged 55 to 64 years, and there has been a rise in more severe injuries including traumatic brain injury and craniofacial fractures.
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http://dx.doi.org/10.1016/j.joms.2019.08.006DOI Listing
February 2020

Cervical necrotising fasciitis: a rare complication of infectious mononucleosis.

BMJ Case Rep 2019 Mar 1;12(3). Epub 2019 Mar 1.

Otolaryngology Head and Neck Surgery, Saint Barnabas Medical Center, Livingston, New Jersey, USA.

Cervical necrotising fasciitis (NF) is an aggressive polymicrobial infection of the subcutaneous tissues in the head and neck. We present a case of a healthy 19-year-old man who developed cervical and upper mediastinal NF after an initial presentation of infectious mononucleosis (IM). He was treated with broad-spectrum antibiotics in addition to incision and drainage of an anterior neck and upper mediastinal abscess. He progressed favourably after ten days of hospitalisation and was discharged home on intravenous antibiotics. This is a unique case of cervical NF as a sequelae of IM in a previously healthy paediatric patient.
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http://dx.doi.org/10.1136/bcr-2018-228172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398802PMC
March 2019

Characterizing genetic variants for clinical action.

Am J Med Genet C Semin Med Genet 2014 Mar 13;166C(1):93-104. Epub 2014 Mar 13.

Genome-wide association studies, DNA sequencing studies, and other genomic studies are finding an increasing number of genetic variants associated with clinical phenotypes that may be useful in developing diagnostic, preventive, and treatment strategies for individual patients. However, few variants have been integrated into routine clinical practice. The reasons for this are several, but two of the most significant are limited evidence about the clinical implications of the variants and a lack of a comprehensive knowledge base that captures genetic variants, their phenotypic associations, and other pertinent phenotypic information that is openly accessible to clinical groups attempting to interpret sequencing data. As the field of medicine begins to incorporate genome-scale analysis into clinical care, approaches need to be developed for collecting and characterizing data on the clinical implications of variants, developing consensus on their actionability, and making this information available for clinical use. The National Human Genome Research Institute (NHGRI) and the Wellcome Trust thus convened a workshop to consider the processes and resources needed to: (1) identify clinically valid genetic variants; (2) decide whether they are actionable and what the action should be; and (3) provide this information for clinical use. This commentary outlines the key discussion points and recommendations from the workshop.
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http://dx.doi.org/10.1002/ajmg.c.31386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158437PMC
March 2014

A mechanism for controlled access to GWAS data: experience of the GAIN Data Access Committee.

Am J Hum Genet 2013 Apr;92(4):479-88

Division of Genomic Medicine, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.

The Genetic Association Information Network (GAIN) Data Access Committee was established in June 2007 to provide prompt and fair access to data from six genome-wide association studies through the database of Genotypes and Phenotypes (dbGaP). Of 945 project requests received through 2011, 749 (79%) have been approved; median receipt-to-approval time decreased from 14 days in 2007 to 8 days in 2011. Over half (54%) of the proposed research uses were for GAIN-specific phenotypes; other uses were for method development (26%) and adding controls to other studies (17%). Eight data-management incidents, defined as compromises of any of the data-use conditions, occurred among nine approved users; most were procedural violations, and none violated participant confidentiality. Over 5 years of experience with GAIN data access has demonstrated substantial use of GAIN data by investigators from academic, nonprofit, and for-profit institutions with relatively few and contained policy violations. The availability of GAIN data has allowed for advances in both the understanding of the genetic underpinnings of mental-health disorders, diabetes, and psoriasis and the development and refinement of statistical methods for identifying genetic and environmental factors related to complex common diseases.
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http://dx.doi.org/10.1016/j.ajhg.2012.08.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617375PMC
April 2013

Incidental genetic findings in randomized clinical trials: recommendations from the Genomics and Randomized Trials Network (GARNET).

Genome Med 2013 30;5(1). Epub 2013 Jan 30.

Center for Biomedical Ethics and Humanities, Box 800758, University of Virginia School of Medicine, 101 Hospital Drive, Barringer 5380, Charlottesville, VA 22908, USA.

Recommendations and guidance on how to handle the return of genetic results to patients have offered limited insight into how to approach incidental genetic findings in the context of clinical trials. This paper provides the Genomics and Randomized Trials Network (GARNET) recommendations on incidental genetic findings in the context of clinical trials, and discusses the ethical and practical issues considered in formulating our recommendations. There are arguments in support of as well as against returning incidental genetic findings in clinical trials. For instance, reporting incidental findings in clinical trials may improve the investigator-participant relationship and the satisfaction of participation, but it may also blur the line between clinical care and research. The issues of whether and how to return incidental genetic findings, including the costs of doing so, should be considered when developing clinical trial protocols. Once decided, plans related to sharing individual results from the aim(s) of the trial, as well as incidental findings, should be discussed explicitly in the consent form. Institutional Review Boards (IRBs) and other study-specific governing bodies should be part of the decision as to if, when, and how to return incidental findings, including when plans in this regard are being reconsidered.
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http://dx.doi.org/10.1186/gm411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706830PMC
May 2014