Biomedical subjects

M Tarabichi

Publications and source records attributed to M Tarabichi.

8 recordsLinked to original sources

PubMed2000

Characteristics of sinus-related pain.

OBJECTIVES: The goal of this study was to determine possible distinctive features of facial pain when caused by chronic sinusitis and to validate the pain characteristics previously described in the literature. METHODS: Included were 82 patients with radiographic and endoscopic evidence of chronic sinusitis and significant facial pain who underwent functional endoscopic sinus surgery and were available for 1-year follow-up. A modified McGill pain questionnaire was filled out before surgery, and follow-up data were obtained at 1 year. RESULTS: At 1 year 38% of patients had persistent facial pain despite the lack of any evidence of persistent sinusitis. A consistent use of pain adjectives and other distinctive features was noted in patients reporting improvement of headache. There was no correlation between the severity of pain and the extent or location of mucosal disease. The site of pain did not correlate with the site of disease. CONCLUSIONS: Sinusitis-related pain has distinctive features that set it apart from primary headache disorders and other causes of facial pain. Nonsinus causes account for the headache in 1 of 3 patients undergoing sinus surgery.

Chronic Disease↗

PubMed2000

Endoscopic management of cholesteatoma: long-term results.

OBJECTIVES: This report evaluates long-term results of transcanal endoscopic management and surveillance of cholesteatoma. METHODS: Sixty-nine ears with acquired cholesteatoma underwent endoscopic transcanal tympanotomy and atticotomy to access and completely remove the sac. Reconstruction with a composite tragal graft was performed in 38 ears, and the cavities were packed open in 31 ears. Office-based endoscopic surveillance and follow-up were performed. RESULTS: Forty-three ears were operated on with the patient under local anesthesia, and 58 were done on an outpatient basis. Three cases were converted into postauricular tympanomastoidectomy. There were no iatrogenic facial nerve injuries. Bone thresholds were stable, except in 1 patient with perilymphatic fistula. Mean follow-up was 41 months, and 19 ears underwent 5 years of follow-up. Six ears required revision surgery, and 9 required office-based minor procedures. CONCLUSIONS: An endoscopic technique allows transcanal, minimally invasive management and surveillance of cholesteatoma with long-term results that compare well to those of postauricular methods.

Cholesteatoma, Middle Ear↗

PubMed1999

Endoscopic middle ear surgery.

One hundred sixty-five middle ear procedures were performed with an endoscope, a camera, and a video monitor instead of the microscope. The endoscope offers the following advantages: 1) it visualizes the whole tympanic membrane and the ear canal without having to manipulate the patient's head or the microscope, 2) it extends the operative field in transcanal procedures into structures usually hidden from the microscope (anterior tympanic perforation, posterior retraction pocket, facial recess, and hypotympanum), and 3) it visualizes structures from multiple angles as opposed to the microscope's single axis along the ear canal. Disadvantages of the endoscope include the one-handed surgical technique, a loss of depth perception, limited magnification, and the need for training. The endoscope holds the greatest promise in tympanoplasty and cholesteatoma surgery and should increase the utilization of transcanal over postauricular procedures.

Audiometry↗

PubMed1998

Microdebrider-assisted uvulopalatoplasty.

This report describes 3 years' experience with the microdebrider as a safe and reasonable alternative to CO2 laser for uvulopalatoplasty. The cost and compact size of the equipment, as well as the ease of surgery, are the main advantages for microdebrider-assisted surgery.

Adult↗

PubMed1997

Endoscopic management of acquired cholesteatoma.

OBJECTIVE: This study aimed to describe and evaluate endoscopic technique for treatment of acquired cholesteatoma. STUDY DESIGN: This study was a case series. SETTINGS: The study was performed in a private otolaryngology practice. PATIENTS: Thirty-eight adult patients with acquired cholesteatoma and no previous ear surgery composed the patient population. INTERVENTION: Thirty-six patients underwent transcanal endoscopic tympanotomy and extended atticotomy with removal of the cholesteatoma sac; the attic defect was reconstructed in 25 patients and was packed open in 11 patients. Two patients underwent traditional postauricular procedures. MAIN OUTCOME MEASURE: The main outcome measure was disease-free ears as evident on: 1) clinical examination at 1 year follow-up for 30 patients and at 2 years for 13 patients; and 2) surgical exploration in 6 patients at 2 years. RESULTS: There were no significant complications associated with the 36 endoscopic procedures: 29 of 30 patients were disease free at 1 year, 10 of 13 were disease free on clinical examination at 2 years, and 4 of 6 were disease free on surgical exploration at 2 years. CONCLUSIONS: Early results indicate that endoscopic removal of cholesteatoma offers a safe and effective transcanal alternative to postauricular procedures.

Adolescent↗

PubMed1994

Transsinus reduction and one-point fixation of malar fractures.

OBJECTIVE: To describe and evaluate transsinus reduction and one-point miniplate fixation of the zygomaticomaxillary buttress for the treatment of tripod malar fractures. DESIGN: A consecutive case series. SETTING: Private otolaryngology practice. PATIENTS: A consecutive sample of 17 patients presenting with isolated tripod malar fractures over a 42-month period. INTERVENTION: A gingivobuccal sulcus incision is made. Access into the maxillary sinus was obtained through an invariably comminuted inferior fracture line. The zygoma was reduced by applying lateral and anterior traction force to the zygomatic recess of the maxillary sinus. Miniplate fixation of the zygomaticomaxillary buttress area was then performed bridging over an area of bone loss and comminution. MAIN OUTCOME MEASURES: Clinical assessment of facial symmetry by patients, physician, and roentgenographic studies. RESULTS: All patients presenting with no comminution of the orbital rim had complete restoration of their premorbid facial symmetry. One of the two patients presenting with comminuted orbital rim had poor results. CONCLUSIONS: This technique is simple, limited, and successful in treating most malar fractures. The lack of comminution of the orbital rim is crucial for the stability of the reduced zygoma. A simple and clinically relevant classification of malar fractures is proposed.

Adolescent↗

PubMed1993

Actinomycosis otomastoiditis.

We reviewed the reported experience with actinomycosis otomastoiditis in the international literature, along with a recent case from our experience. All recently reported cases presented with persistent drainage and partial response to multiple courses of antibiotics. Diagnosis was uniformly made postoperatively, and the outcome was excellent following a prolonged course of antibiotic treatment.

Actinomycosis↗

PubMed1993

Finite element analysis of airflow in the nasal valve.

We digitized the outline of the nasal cavity from images obtained after applying contrast material to the nose. A computer-aided simulation of flow was undertaken in the sagittal plane in the anterior nasal cavity. Previous work on the nasal valve was reviewed. Our results showed that the nasal valve is an oblique structure bounded laterally by the caudal end of the upper lateral cartilage, medially by the septum, and ventrally by the inferior rim of the piriform aperture. We found that this rim, projecting from the floor of the nose, produces an uneven distribution of airflow through the valve with most of the flow occurring in the ventral segment. Removal of this rim should result in a more even distribution of flow across the valve.

Biophysical Phenomena↗