Biomedical subjects

Patrick J Antonelli

Publications and source records attributed to Patrick J Antonelli.

42 records · Page 3Linked to original sources

PubMed2002

Defining tympanostomy tube plugs.

OBJECTIVES: To define the composition of tympanostomy tube plugs because selecting or developing effective solvents depends on such knowledge. STUDY DESIGN: Prospective, in vitro laboratory study. METHODS: Luminal contents of 105 plugged, microscopically removed tympanostomy tubes were expressed, pooled, acid hydrolyzed, and passed through a high-performance liquid chromatography column. Retention times were compared with high-performance liquid chromatography standards to develop free amino acid and monosaccharide profiles. Cerumen, blood, and chronic mucoid effusion (collected during myringotomy) were pooled and subjected to the same analysis. The elution profiles of each substance were compared to determine which substance most closely matched the plugs. RESULTS: High-performance liquid chromatography amino acid and monosaccharide analysis demonstrated greatest similarity between tympanostomy tube plugs and mucoid effusion. CONCLUSIONS: Tympanostomy tube plug composition is more similar to mucoid effusion than to blood or cerumen. Solvents to open plugged tympanostomy tubes should be directed against the components of mucoid effusion.

Amino Acids↗

PubMed2002

Opening plugged tympanostomy tubes.

OBJECTIVE: To determine the most effective solvents for dissolving plugged tympanostomy tubes. STUDY DESIGN: In vitro laboratory study. METHODS: Twelve solvents (including ototopical antibiotics and water) were applied to fluoroplastic tympanostomy tubes (n = 260) plugged with dried mucoid middle ear effusion in an ear canal-tympanic membrane model. Time to clearance of the tympanostomy tubes was both visually and tympanometrically determined. RESULTS: Vinegar (P =.0030) and hyaluronidase solutions (P =.0030) were significantly better solvents than water. CONCLUSION: Vinegar and hyaluronidase solutions are more likely to clear plugged tympanostomy tubes than water and ototopical antibiotics, but vinegar is the preferred solution because of its known relative safety for use in the ear.

Equipment Design↗

PubMed2002

External auditory canal stenosis after radiation therapy.

OBJECTIVES: To determine whether the risk of external auditory canal stenosis from external-beam radiation therapy is dose dependent. STUDY DESIGN: Retrospective chart review. METHODS: The presence of external auditory canal disease was recorded for patients who received low-dose (e.g., lymphoma [20-40 Gy]), medium-dose (e.g., chemodectoma [40-55 Gy]), or high-dose (e.g., parotid and nasopharyngeal neoplasms [55-75 Gy]) external-beam radiation therapy from 6 months to over 8 years following treatment. The incidence of external auditory canal disease was compared between groups. RESULTS: None of 13 low-dose, none of 19 medium-dose, and 8 of 91 (8.7%) high-dose external-beam radiation therapy subjects developed ipsilateral external auditory canal stenosis. No external auditory canal stenosis developed in patients treated with high-dose external-beam radiation therapy in the absence of parotid surgery. External auditory canal stenosis developed only in patients treated with parotidectomy and high-dose external-beam radiation therapy (P =.0059), and all of these cases of external auditory canal stenosis developed within 3 years of radiation therapy. CONCLUSIONS: High dose external-beam radiation therapy alone does not significantly predispose patients to external auditory canal stenosis. However, combined high-dose external-beam radiation therapy and surgery around the external auditory canal do significantly increase the risk of external auditory canal stenosis.

Constriction, Pathologic↗

PubMedDate not supplied

Management of acoustic schwannoma.

PURPOSE: To discuss the optimal management for patients with acoustic schwannoma. MATERIALS AND METHODS: Review of the pertinent literature. RESULTS: Microsurgery, stereotactic radiosurgery, and fractionated radiotherapy result in cure rates that approximate 90% at 5 years. Depending on tumor extent and surgical approach, the morbidity of microsurgery may exceed that of stereotactic radiosurgery and fractionated radiotherapy. Patients with useful hearing before treatment may have a higher likelihood of hearing preservation after radiotherapy compared with radiosurgery. CONCLUSION: Both microsurgery and radiosurgery are good options for patients with tumors less than 3 cm. Depending on tumor extent and the surgical approach, the morbidity of microsurgery may exceed that of radiosurgery. Patients with useful hearing may have a higher likelihood of hearing preservation after radiotherapy. Microsurgery is preferred for patients in whom the disease progresses after initial irradiation and in patients with tumors larger than 3 cm.

Combined Modality Therapy↗

PubMedDate not supplied

Complications of cochlear implant placement with minimal hair shave.

OBJECTIVE: The goal of this study was to determine if a change to minimal-hair shave preparation has altered the incidence of complications after cochlear implant surgery. MATERIALS AND METHODS: Charts were reviewed on 158 consecutive patients that underwent primary cochlear implant surgery for evidence of minor and major surgical complications with full- or minimal-hair shave preparation. RESULTS: Complications were noted within 6 weeks in 5 of 105 patients in the minimal-hair shave group and 3 of 53 in the full-hair shave group (4.8% v 5.7%, P =.53). Delayed complications were noted in 3 within the minimal-shave group and 1 within the full-shave group (2.9% v 1.9%, P =.58). Only 1 wound complication required replacement of the cochlear implant. CONCLUSIONS: There is no evidence that minimal-hair shave adversely affects rates of wound complications in patents undergoing cochlear implant surgery. Therefore, minimal preoperative scalp shave may be an acceptable alternative to the traditional hair shaving technique.

Adolescent↗

PubMedDate not supplied

Cochlear implant integrity after adenoidectomy with Coblation and monopolar electrosurgery.

PURPOSE: Conventional electrosurgical adenoidectomy has been deemed contraindicated in subjects with cochlear implants (CIs) because of risk to the CI and the auditory neurons. No published studies have evaluated the safety of electrosurgical adenoidectomy techniques with CIs. The goal of this study was to compare the impact of monopolar electrosurgery and Coblation radiofrequency bipolar electrosurgery on CI integrity. METHODS: Twelve fresh, cadaveric pigs received unilateral CIs, then the nasopharynx was treated for 15 to 30 minutes with continuous monopolar electrosurgery or Coblation. CIs were tested by the manufacturer for device integrity before and after treatment. RESULTS: Integrity was maintained in all CIs treated with either monopolar or Coblation electrosurgery. CONCLUSIONS: Although the safety of electrosurgical adenoidectomy after CI placement remains unproven, these observations suggest that judicious use of conventional monopolar and Coblation electrosurgery in adenoidectomy does not convey a serious risk to CI integrity. Theoretical considerations favor the use of Coblation over monopolar electrosurgery in CI recipients.

Adenoidectomy↗