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  1. Article ; Online: Systemic Bevacizumab for Recurrent Respiratory Papillomatosis: A Single Institution's Experience.

    So, Raymond J / Rayle, Christopher / Joo, Henry H / Huang, Emily Y / Seiwert, Tanguy Y / Raabe, Eric H / Best, Simon R

    The Laryngoscope

    2024  

    Abstract: Objectives: Medical therapies to limit disease recurrence are critically needed for recurrent respiratory papillomatosis (RRP). Systemic bevacizumab is emerging as an exciting adjuvant therapy toward this end, but uptake has been poor due to the lack of ...

    Abstract Objectives: Medical therapies to limit disease recurrence are critically needed for recurrent respiratory papillomatosis (RRP). Systemic bevacizumab is emerging as an exciting adjuvant therapy toward this end, but uptake has been poor due to the lack of experience and awareness of best prescribing practices. The objective of this study was to describe a single tertiary care academic medical center's experience using systemic bevacizumab for the treatment of RRP.
    Methods: A retrospective review was performed to identify patients with RRP on systemic bevacizumab. Demographic and clinical characteristics, findings on imaging reports, and disease response at all anatomic subsites involved in papilloma were documented.
    Results: Of the 17 RRP patients on systemic bevacizumab, 9 (52.9%) were male, and 12 (70.6%) were diagnosed with juvenile-onset RRP. The total lifetime number of surgeries was high, with more than half (n = 9; 52.9%) undergoing more than 50 surgeries. Following induction of systemic bevacizumab, a significant reduction in patients with laryngeal (n = 15; 94.1% vs. n = 7; 41.2%, p < 0.001) and tracheal (n = 11; 64.7% vs. n = 5; 29.4%, p = 0.04) RRP was noted. Surgical frequency was significantly lower following systemic bevacizumab (2.5 vs. 0.5 surgeries per year; p < 0.001). The most common complications were new-onset hypertension (n = 4; 23.5%) and proteinuria (n = 5; 29.4%).
    Conclusion: Systemic bevacizumab is effective in reducing the number of surgeries needed for RRP while exhibiting a relatively safe complication profile. Papillomas in the larynx and trachea are most responsive to systemic bevacizumab, while pulmonary RRP is most likely to exhibit a partial-to-stable response.
    Level of evidence: 4 Laryngoscope, 2024.
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.31387
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impact of Ergonomics on Muscle Fatigue During Surgical Drilling Using Surface Electromyography.

    Joo, Henry H / Formeister, Eric / Pozin, Michael / Fatollahkhani, Paria Arfa / Carey, John / Raghavan, Preeti / Galaiya, Deepa

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2024  

    Abstract: Objective: To investigate the relationship between ergonomic positions and electromyographic muscle activity during otologic drilling.: Study design: Cross-over experimental trial.: Setting: Tertiary Academic Medical Center.: Methods: Surgeon ... ...

    Abstract Objective: To investigate the relationship between ergonomic positions and electromyographic muscle activity during otologic drilling.
    Study design: Cross-over experimental trial.
    Setting: Tertiary Academic Medical Center.
    Methods: Surgeon participants were tasked with delicate eggshell drilling in 3 different seated positions: "neutral," "slouched," and "craned." Surface electromyography (sEMG) sensors recorded the amplitude and frequency of muscle activity. The joint analysis of spectrum and amplitude (JASA) method, which combines temporal trends in frequency and amplitude, was used to identify trials that exhibited patterns of fatigue.
    Results: The sEMG amplitude and frequency responses demonstrated wide temporal changes. In a majority of experiments, amplitude increased over the course of the experiment, while frequency remained more stable. On analysis of variance testing, only the mean frequency of the deltoid differed significantly between postures (P = .02). Under the JASA framework, external carpi radialis and upper trapezius experienced fatigue in nearly half of the trials regardless of position (47% vs 49%). The upper trapezius demonstrated fatigue during 46% and 69% of the "craned" and "slouched" trials, respectively, compared to just 31% of the "neutral" trials. Fewer attendings demonstrated upper trapezius fatigue compared to trainees (33% vs 62%). Female surgeons experienced fatigue in more trials than male counterparts (73% vs 25%).
    Conclusion: This study highlights a first step in quantifying the relationship between operating postures and muscle fatigue. Results suggest that specific muscle groups are more susceptible to fatigue; gender and experience may also impact muscle activity.
    Language English
    Publishing date 2024-02-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.687
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  3. Article ; Online: Association Between Hearing Difficulty and Mobility in Adults of All Ages: National Health Interview Survey.

    Joo, Henry H / Huang, Emily Y / Schoo, Desi / Ward, Bryan / Chen, Jenny X

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2023  Volume 170, Issue 4, Page(s) 1059–1065

    Abstract: Objective: To investigate the relationship between hearing difficulty and measures of mobility for US adults.: Study design: Cross-sectional study.: Setting: 2021 National Health Interview Survey.: Methods: The survey asked US adults about ... ...

    Abstract Objective: To investigate the relationship between hearing difficulty and measures of mobility for US adults.
    Study design: Cross-sectional study.
    Setting: 2021 National Health Interview Survey.
    Methods: The survey asked US adults about hearing difficulty and mobility measures, including difficulty walking 100 yards, difficulty climbing 12 steps, and injury from falling within the past 3 months. Multivariable logistic regressions examined the associations between hearing and mobility outcomes, controlling for visual difficulty, medical comorbidities, and various demographic characteristics (age [18-39, 40-64, 65+], race/ethnicity, sex, socioeconomic status).
    Results: The 2021 NHIS surveyed 29,467 adults, representing 253 million people in weighted responses (52% female; mean age 48.3, standard deviation = 18.6). Controlling for covariates, hearing difficulty was associated with increased odds of difficulty walking 100 yards (odds ratio, OR = 1.47, P < .001), difficulty climbing stairs (OR = 1.62, P < .001), and injury from falling in the past 3 months (OR = 1.51, P < .001). There was a significant interaction between age and hearing difficulty for injurious falls; stratifying by age revealed that younger adults (ages 18-39) with hearing difficulty were more likely to report recent harmful falls than their normal hearing peers; this increased risk was greater in magnitude than that observed comparing older adults with and without hearing difficulty.
    Conclusion: The hearing difficulty is associated with worsened mobility for US adults and may be a stronger independent predictor of injury from falls for younger adults as compared to older adults. These findings can inform interventions to reduce the burden of declining mobility in adults with hearing difficulty.
    MeSH term(s) Humans ; Female ; Aged ; Middle Aged ; Male ; Cross-Sectional Studies ; Mobility Limitation ; Surveys and Questionnaires ; Hearing Loss/epidemiology ; Hearing
    Language English
    Publishing date 2023-11-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.593
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  4. Article ; Online: Tremor Assessment in Robot-Assisted Microlaryngeal Surgery Using Computer Vision-Based Tool Tracking.

    Cho, Sue M / Joo, Henry H / Golla, Pranathi / Sahu, Manish / Shankar, Ahjeetha / Trakimas, Danielle R / Creighton, Francis / Akst, Lee / Taylor, Russell H / Galaiya, Deepa

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2024  

    Abstract: Objective: Use microscopic video-based tracking of laryngeal surgical instruments to investigate the effect of robot assistance on instrument tremor.: Study design: Experimental trial.: Setting: Tertiary Academic Medical Center.: Methods: In ... ...

    Abstract Objective: Use microscopic video-based tracking of laryngeal surgical instruments to investigate the effect of robot assistance on instrument tremor.
    Study design: Experimental trial.
    Setting: Tertiary Academic Medical Center.
    Methods: In this randomized cross-over trial, 36 videos were recorded from 6 surgeons performing left and right cordectomies on cadaveric pig larynges. These recordings captured 3 distinct conditions: without robotic assistance, with robot-assisted scissors, and with robot-assisted graspers. To assess tool tremor, we employed computer vision-based algorithms for tracking surgical tools. Absolute tremor bandpower and normalized path length were utilized as quantitative measures. Wilcoxon rank sum exact tests were employed for statistical analyses and comparisons between trials. Additionally, surveys were administered to assess the perceived ease of use of the robotic system.
    Results: Absolute tremor bandpower showed a significant decrease when using robot-assisted instruments compared to freehand instruments (P = .012). Normalized path length significantly decreased with robot-assisted compared to freehand trials (P = .001). For the scissors, robot-assisted trials resulted in a significant decrease in absolute tremor bandpower (P = .002) and normalized path length (P < .001). For the graspers, there was no significant difference in absolute tremor bandpower (P = .4), but there was a significantly lower normalized path length in the robot-assisted trials (P = .03).
    Conclusion: This study demonstrated that computer-vision-based approaches can be used to assess tool motion in simulated microlaryngeal procedures. The results suggest that robot assistance is capable of reducing instrument tremor.
    Language English
    Publishing date 2024-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.714
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ul II Zs.83/a: Show issues Location:
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