Publications by authors named "Skylar Trott"

5 Publications

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Systematic review of endoscopic-assisted surgical management for congenital nasolacrimal duct obstruction.

Int J Pediatr Otorhinolaryngol 2020 Dec 15;139:110448. Epub 2020 Oct 15.

Department of Otolaryngology, University of Kentucky Medical Center, Lexington, KY, USA. Electronic address:

Objectives: Epiphora is a common presenting complaint in infants affecting up to 6% of infants in the United States. It is most frequently due to congenital anomalies of the nasolacrimal duct system, termed congenital nasolacrimal duct obstruction (CNLDO). Nasolacrimal duct probing is widely accepted as the primary surgical intervention in cases that fail conservative management. Recently, nasal endoscopy has been combined with traditional probing to improve success rates and outcomes. Several studies have been conducted, but the results have been inconclusive overall. The goal of this systematic review is to examine the existing literature on the role of nasal endoscopy during nasolacrimal duct probing and evaluate patient outcomes.

Methods: A systematic search was performed in PubMed, MEDLINE, The Cochrane Library, ClinicalTrials.gov, LILAC, and EMBASE to identify peer-reviewed research. Eligible studies were those containing original peer-reviewed research in English addressing nasolacrimal duct probing for congenital nasolacrimal duct obstruction in conjunction with nasal endoscopy. Two investigators independently reviewed all articles and extracted data. Bias was assessed using the Cochrane Collaboration's tool, the Newcastle-Ottawa Assessment scale, and the NIH Quality Assessment scale.

Results: A literature review ultimately yielded 11 articles that were selected and included in our analysis. Of the seven case series, the success rate was 92.5% for a total of 492 eyes. Of the four cohort/case-control studies, the success rate in conventional probings was 75.3% for a total of 293 eyes. In probings with nasal endoscopy, the success rate was 95.3% for 162 eyes. Overall, there was a high risk of bias and variation in data reporting amongst studies.

Conclusion: Infants with congenital nasolacrimal duct obstruction that does not resolve with conservative treatment often require surgical intervention. Based on this systematic review of the current literature, nasal endoscopy is a useful adjunct for nasolacrimal duct probing.
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http://dx.doi.org/10.1016/j.ijporl.2020.110448DOI Listing
December 2020

Immune System Activation in Perioperative Thrombectomy Patients: Preliminary Retrospective Study.

World Neurosurg 2019 Aug 14;128:e966-e969. Epub 2019 May 14.

College of Medicine, University of Kentucky, Lexington, Kentucky, USA; Department of Neurology, University of Kentucky, Lexington, Kentucky, USA; Department of Neuroscience, University of Kentucky, Lexington, Kentucky, USA; Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA; Department of Radiology, University of Kentucky, Lexington, Kentucky, USA. Electronic address:

Background: Ischemic stroke is a devastating condition resulting in significant morbidity. Mechanical thrombectomy is now standard for large vessel occlusive stroke. Neuroinflammation is known to play important roles in ischemic stroke. Our aims were to examine our thrombectomy procedures and preliminarily examine systemic immune response in relation to thrombectomy changes.

Methods: A retrospective review was conducted on mechanical thrombectomy cases from July 2011 through December 2015. Primary outcomes were time to recanalization, final Thrombolysis in Cerebral Infarction score, procedural complications, National Institutes of Health Stroke Scale improvement, and changes in white blood cell (WBC) count.

Results: One-hundred and twenty-nine procedures were performed. We found a significant difference between WBC count on admission and WBC count post thrombectomy day 1 for patients with >90 minutes to recanalization (P = 0.006107). There was a positive association between WBC change and absolute National Institutes of Health Stroke Scale change among females (P = 0.0273) but not among males.

Conclusions: Overall, we found that systemic immune response has close relationships with speed of recanalization and preliminarily may shift differently on the basis of sex.
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http://dx.doi.org/10.1016/j.wneu.2019.05.044DOI Listing
August 2019

Hormones and Hearing: Central Auditory Processing in Women.

J Am Acad Audiol 2019 06 25;30(6):493-501. Epub 2018 Sep 25.

Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, KY.

Background: Estrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.

Purpose: The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.

Research Design: A prospective, group comparison study.

Study Sample: Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.

Data Collection And Analysis: Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.

Results: Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test-Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.

Conclusions: Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.
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http://dx.doi.org/10.3766/jaaa.17123DOI Listing
June 2019

Laparoscopic ventral hernia repair with primary fascial closure versus bridged repair: a risk-adjusted comparative study.

Surg Endosc 2016 08 17;30(8):3231-8. Epub 2015 Nov 17.

Department of Surgery, University of Kentucky, C-225 Chandler Medical Center, 800 Rose Street, Lexington, KY, 40536, USA.

Background: Laparoscopy, specifically the bridged mesh technique, is a popular means used for ventral hernia repair. While laparoscopy has decreased the incidence of surgical site infection (SSI), hernia recurrence rates remain unchanged. Some surgeons advocate laparoscopic primary fascial closure (PFC) with placement of intraperitoneal mesh to decrease recurrence rates. We hypothesize that in patients undergoing laparoscopic ventral hernia repair (LVHR), PFC compared to a bridged mesh repair decreases hernia recurrence rates.

Methods: A multicenter, retrospective database of all ventral hernia repairs performed from 2010-2012 was accessed. Patients who underwent LVHR with mesh were reviewed. Patients who had PFC were compared to bridged repair. Primary outcome was hernia recurrence determined by clinical examination or CT scan. Secondary outcomes included SSI and seroma formation.

Results: A total of 1594 patients were identified. Following exclusion, a total of 196 patients were left who underwent LVHR with a mean follow-up period of 17.5 months. Ninety-seven patients underwent PFC, while 99 underwent bridged repairs. Initial comparisons between both groups was negative for any significant statistical difference in terms of recurrence, seroma formation, SSI, deep/organ space SSI, reoperation, and readmission. The same initial findings held true during subgroup analysis. Propensity score analysis was then performed for recurrence, seroma, and SSI controlling for age, gender, immune status, ASA class, BMI, smoking status, and acute repair. No statistically significant differences were identified in either group.

Conclusion: Primary fascial closure during laparoscopic hernia repairs did not result in reduced recurrence, seroma, and SSI as compared to bridge repairs in a retrospective, multi-institutional study. However, additional research is needed to further evaluate benefits to the patient in terms of pain, function, cosmesis, and overall satisfaction. Randomized, blinded, control trials should focus on these parameters in future investigations.
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http://dx.doi.org/10.1007/s00464-015-4644-5DOI Listing
August 2016

The dispersal process of asexual propagules and the contribution to population persistence in Marchantia (Marchantiaceae).

Am J Bot 2014 Feb 5;101(2):348-56. Epub 2014 Feb 5.

Department of Biology, University of Kentucky, Lexington, Kentucky 40506-0225 USA.

Premise Of The Study: The dispersal process involves emigration from a focal source, dispersal through the landscape, and immigration into a new population or habitat. Despite the fact that dispersal is vital for the long-term persistence of a species, key stages of the process are unknown or understudied for many species, including the importance and contribution of asexual reproduction. Focusing only on a single stage in the dispersal process may give an incomplete and potentially flawed picture of the effects of asexual reproduction on metapopulation dynamics in plant species.

Methods: Using a multifaceted approach that combines laboratory experiments, field studies, and mathematical models, we quantify the production, dispersal, and survival of immigrants of water-dispersed asexual offspring (gemmae) of the clonal liverwort Marchantia inflexa.

Key Results: Compared to female plants, male plants of Marchantia inflexa produce gemmae more quickly and in higher numbers, but due to desiccation have lower gemmae survival rates. Gemmae move up to 20 cm per minute in light rain, suggesting they can leave the source population. Long distance dispersal of gemmae is supported by the mathematical analysis of unisexual metapopulations. Upon reaching the new habitat, gemmae survival is high if they stay moist.

Conclusions: By integrating multiple experiments to quantify the effects of gemmae on metapopulation dynamics, we found that different stages of dispersal can lead to different conclusions on which sex has an advantage. Gemmae are critical for the maintenance of both sexes, the persistence of single-sex metapopulations and species, and the invasibility of clonal organisms.
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http://dx.doi.org/10.3732/ajb.1300339DOI Listing
February 2014