Chondro-osseous respiratory epithelial hamartoma of the sinonasal tract.
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Adult↗
Biomedical subjects
Peter J Catalano
Publications and source records attributed to Peter J Catalano.
Initial U.S. pilot study: palatal implants for the treatment of snoring.
OBJECTIVE: To assess efficacy of polyethylene terephthalate (PET) implants in the soft palate for the treatment of socially significant snoring. DESIGN: A prospective, interventional case series. SETTING: Hospital-based multi-specialty clinic. PATIENTS: Twenty-five consecutive patients with socially significant snoring without history of obstructive sleep apnea. INTERVENTION: Three PET implants were inserted into the soft palate of each patient (Pillar procedure, Restore Medical, Inc., St. Paul, Minnesota). MAIN OUTCOME MEASURE: Change in snoring severity measured by the bed partner using a 10-centimeter visual analog scale (VAS) where 0 = "no snoring noise" and 10 = "extreme snoring noise causing (the bed partner) to leave the bedroom." RESULTS: Ninety-day follow-up data was collected for 21 patients. Four patients had incomplete follow-up. Snoring VAS rated by the bed partner had a baseline mean value of 8.5 +/- 1.4, which decreased to 5.0 +/- 2.1 at 30 days and to 4.4 +/- 2.5 at 90 days (P < 0.001). All patients tolerated the procedure well and no procedure-related complications were observed. Two implants partially extruded in 1 patient within the 90-day follow-up period, for an implant partial extrusion rate of 2.7% (2/75 implants) and patient partial extrusion rate of 4% (1/25 patients). At 90 days, 75% of patients and 90% of their bed partners recommended the procedure. CONCLUSIONS: In this case series, PET implants into the soft palate significantly reduced snoring with few extrusions and no complications. Controlled studies are needed to confirm effectiveness and to refine patient selection criteria. EBM RATING: C-4.
Adult↗
Diagnosis and management of lateral semicircular canal benign paroxysmal positional vertigo.
OBJECTIVE: Describe the diagnosis, treatment, and outcome of a group of 20 patients with lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). STUDY DESIGN AND SETTING: Retrospective review of 20 patients with LSC-BPPV (10 with geotropic and 10 with apogeotropic nystagmus) presenting to a tertiary balance center. Diagnosis was confirmed with infrared nystagmography in Dix-Hallpike positioning tests and supine positional tests. Patients were treated with one or more particle repositioning maneuvers. RESULTS: Addition of supine positional nystagmus tests to Dix-Hallpike positioning testing improves sensitivity in the diagnosis of LSC-BPPV. Treatment outcomes in the apogeotropic LSC-BPPV group were poorer than the geotropic LSC-BPPV group. SIGNIFICANCE: Adding supine positional testing to routine vestibular diagnostic testing will increase the identification of LSC-BPPV. Apogeotropic LSC-BPPV is more challenging to treat.
Adult↗
Office versus operating room insertion of the bone-anchored hearing aid: a comparative analysis.
BACKGROUND: The Bone-anchored Hearing Aid is indicated for patients with unilateral deafness and/or an irreversible conductive hearing loss. The insertion of this device is usually performed in the operating room under intravenous sedation or general anesthesia. We suggest that the placement of the abutment can occur easily and safely in the clinic setting, reducing time and costs for both the patient and the physician. STUDY DESIGN: Retrospective study. METHODS: Ten patients requiring 11 devices (1 bilateral) were implanted with the Bone-anchored Hearing Aid device in the outpatient clinic and another 8 patients were implanted in the operating room. All office procedures were done under local anesthesia; operating room procedures used either general anesthesia or intravenous sedation. Follow-up occurred over 12 months. Time required, cost of the procedure, and other logistical concerns between operating room and office-based insertion were evaluated and compared. RESULTS: When performed in the office, patient fees were reduced by 31%, and patient time investment was reduced 73%. Physician time was reduced by 50%. After office-based insertion, patients were able to return to their normal routine immediately after the procedure, and no chaperone or designated driver was required. No infection or complications occurred in either group. CONCLUSION: Bone-anchored Hearing Aid insertion in the clinic setting is safe and cost-effective, saving the patient and physician significant time and resources.
Aged↗
The minimally invasive sinus technique: theory and practice.
Minimally invasive sinus technique (MIST) is a targeted endoscopic intervention, introduced in 1994, with goals virtually identical to those originally reported for FESS but with distinct differences. The procedure, as outlined in the following section, is the only stepwise intranasal intervention with a defined beginning and end for all patients regardless of disease severity, thereby standardizing the procedure for surgeons and patients alike. This elegant, reproducible method avoids unnecessary disruption of normal mucosa while restoring mucociliary clearance through the primary birth ostia and reduces operative morbidity.
Endoscopy↗
Minimally invasive sinus technique: what is it? Should we consider it?
PURPOSE OF REVIEW: To understand the theory and application of the surgical model for endoscopic sinus surgery termed minimally invasive sinus technique (MIST). In simple terms: What is MIST? When should we use it? Does it work? RECENT FINDINGS: Several recent publications have addressed the efficacy of MIST. Using reliable outcome instruments and a 23-month follow-up period, results following MIST were found to equal or surpass those following functional endoscopic sinus surgery (FESS). These results were valid across the spectrum of disease severity. Other reports address the reduced revision rate (compared with FESS) following initial intervention with MIST, the potential to markedly reduce the rate of intranasal synechiae, and the reduction in immediate postoperative morbidity. SUMMARY: The authors believe that MIST should be considered as the initial surgical intervention offered to patients undergoing surgery for the treatment of chronic rhinosinusitis.
Chronic Disease↗
Evaluation of middle meatal stenting after minimally invasive sinus techniques (MIST).
OBJECTIVES: In this study, we compared postoperative synechia rates and morbidity for different middle meatal (MM) stents after minimally invasive sinus techniques (MIST). STUDY DESIGN: In a prospective study, we included 100 patients with bilateral chronic sinusitis undergoing MIST at a tertiary care facility with a single surgeon. METHODS: For all patients, MeroGel stents were placed in the right MM, Gelfilm stents were placed in the left MM. Follow-up consisted of 3 postoperative visits between weeks 1 and 12 with endoscopic evaluation for synechia, granulation tissue, stent retention, nasal obstruction, headache, and infection. RESULTS: Synechia developed in 4 patients on the left and in none on the right (P = 0.04). There were no significant side-specific differences regarding postoperative nasal congestion, headache, or sinusitis. Mean stent retention time was 7.9 days for MeroGel and 5.6 days for Gelfilm (P = 0.0004). CONCLUSION: Compared with Gelfilm, Merogel MM stents produced less synechia; Merogel retains its position in the MM longer than Gelfilm; and the incidence of postoperative MM synechia can be reduced when absorbable MM stents are used in conjunction with MIST.
Endoscopy↗
Whether the improvement seen following MIST was due to surgery or a post-operative DepoMedrol injection.
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Anti-Inflammatory Agents↗