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Biomedical subjects

Ioana Schipor

Publications and source records attributed to Ioana Schipor.

5 recordsLinked to original sources
PubMed2006

Microdebrider decompression of schwannoma: a novel method of excising a neck mass.

OBJECTIVE: This case report describes the excision of a large neck neurofibroma causing compression of the esophagus and airway in a young patient with neurofibromatosis type 2 (NF2). At the conclusion of this article, readers should be able to describe a novel method of excising large encapsulated neck masses using microdebridement for decompression. The safety and efficacy of this method is discussed. STUDY DESIGN: The subject of this report was a 26-year-old woman with NF2. She presented with an enlarging right neck mass extending from the mandible to the clavicle that was compressing both her airway and esophagus. Given her auditory brainstem implant, unipolar cautery was contraindicated. Therefore, it was planned to decompress the patient's neck mass using a microdebrider before attempting to fully dissect out the mass. METHODS: The neck mass was exposed and then entered. Using a Xomed XPS microdebrider (Medtronic Inc., Minneapolis, MN), the mass was debrided and debulked in all directions taking care not to violate the capsule. After this, the entire capsule was dissected out using only bipolar cautery and suture ligatures for hemostasis. RESULTS: Microdebrider decompression of the neck neurofibroma allowed for preservation of the capsule without injuring vital structures in the neck. Postoperatively, the patient's swallowing and laryngeal function improved markedly. CONCLUSION: Microdebrider debulking before dissection of the patient's large neck mass safely relieved compression of the airway and esophagus. This method may be applied to other large benign masses in the neck as well.

Adult↗
PubMed2004

Evidence of bacterial biofilms in human chronic sinusitis.

The purpose of this study was to evaluate whether bacterial biofilms exist on the sinus mucosa surfaces of human subjects with recalcitrant chronic sinusitis. Scanning electron microscopy was used to evaluate patients with continued symptoms of chronic sinusitis despite prior appropriate medical and surgical management. Morphologic structures that confirm the presence of bacterial biofilms were identified on the sinus mucosa of patients infected with Pseudomonas aeruginosa, a known biofilm former. The presence of bacterial biofilms may explain the recalcitrant nature of some forms of chronic sinusitis.

Biofilms↗
PubMedDate not supplied

Surgical decisions in the management of frontal sinus osteomas.

BACKGROUND: The development of chronic rhinosinusitis, a mucocele, or persistent headaches is a common indication for the removal of a frontal sinus osteoma. The best surgical approach to ensure complete and safe removal of the lesion is less clearcut. The advent of specialized frontal sinus instruments, angled endoscopes, and surgical navigational systems has made removal of frontal sinus osteomas possible through an endoscopic approach. The aim of this study is to review our recent experience with the surgical management of frontal sinus osteomas, and the anatomic features that make specific lesions more or less amenable to endoscopic resection. METHODS: A retrospective review of all frontal sinus osteomas surgically resected from the years 1999 to 2003 was used. This period was selected to reflect the invention and popularization of surgical navigation systems and specialty instruments designed specifically for the frontal sinus. CT scans, operative reports and postoperative course were reviewed. RESULTS: Nine patients were identified. A grading system was devised to reflect the three variables involved in the limitations for endoscopic removal. These are the location of the base of attachment, relative size to the frontal recess, and location in relation to a virtual sagittal plane through the lamina papyracea. Three osteomas were removed through an endoscopic approach. Four were removed by a combined osteoplastic flap and endoscopic dissection of the frontal recess. Two were removed through an osteoplastic flap with obliteration of the sinus. CONCLUSION: The ability to remove a frontal sinus osteoma endoscopically can be determined preoperatively, taking into account the location and size of the lesion. There is still a role for external procedures in the surgical management of these lesions, and such procedures may be combined with endoscopic techniques for optimal results.

Adult↗
PubMedDate not supplied

Quantification of ciliary beat frequency in sinonasal epithelial cells using differential interference contrast microscopy and high-speed digital video imaging.

BACKGROUND: Mucociliary clearance is a critical upper airway host defense mechanism. Ciliated epithelium in the mammalian airway continually beat at a baseline frequency. Importantly, during times of stress such as exercise or infection, the cilia beat faster to increase clearance. Nasal epithelial ciliary beat frequency (CBF) has been analyzed previously in ex vivo specimens using a variety of methods including photodiode detectors and conventional video recording. Recent studies performed using lower airway ciliated mucosa have shown poor correlation between CBF quantified by photodiode/conventional video and those using high-speed digital video capture at temperatures close to physiological temperatures. Thus, to more rigorously interrogate sinonasal CBF at physiological conditions, we have incorporated a high-speed digital video camera to our CBF analysis system. This is the first report of sinonasal epithelial CBF analysis performed using high-speed video digital analysis. METHODS: Ex vivo samples of sinonasal epithelium were placed in lactated Ringer's in a temperature-controlled microscope stage chamber. An edge of tissue containing beating cilia was observed at a magnification of 630x using differential interference contrast microscopy. The images were captured using a high-speed digital camera with a sampling rate of 250 frames per second. CBF was determined using computerized data analysis. RESULTS: The mean nasal CBF was calculated from a minimum of five regions for each sample. Temperature curves were generated from tissue obtained from chronically infected subjects. CONCLUSION: Analysis of high-speed digital video capture of sinonasal CBF observed under differential interference contrast microscopy is a powerful method to investigate environmental as well as host influences on mucociliary clearance within the upper airways.

Cilia↗