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Khaleghi M, Otto B, Carrau R, Abouammo MD, Prevedello DM. Correction to: Customized ventral bony and dural opening in the transplanum/transtuberculum and transclival variants of extended endoscopic endonasal approach to suprasellar craniopharyngiomas: an approach‑based stepwise cadaveric dissection and clinical applicability. Acta Neurochir (Wien) 2024; 166:205. [PMID: 38713321 DOI: 10.1007/s00701-024-06095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Mehdi Khaleghi
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Bradly Otto
- Department of Otolaryngology‑Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology‑Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Moataz D Abouammo
- Department of Otolaryngology‑Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
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Khaleghi M, Carlstrom LP, Callejas CA, Kobalka P, Carrau R, Prevedello DM. Modified Function-Preserving Endoscopic Endonasal Extracapsular Resection of a Large Orbital Apex Cavernous Hemangioma. Oper Neurosurg (Hagerstown) 2024:01787389-990000000-01135. [PMID: 38651862 DOI: 10.1227/ons.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/09/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND AND IMPORTANCE Various invasive oculoplastic procedures are commonly utilized to control the rectus muscles and widen the surgical corridor through the endoscopic endonasal removal of large orbital apex cavernous hemangiomas (OACHs). They require additional transconjunctival incision, rectus muscle insertional retraction, or muscle deinsertion at the globe that might not be safe and lead to prolonged postoperative extraocular muscle dysfunction. In this article, the authors described a modified 3-handed extracapsular technique for the resection of a large OACH without an additional procedure for rectus muscle control. The aim is to achieve a safe gross total tumor removal while minimizing the procedure-related complications. An intraoperative video is included, along with a stepwise cadaveric dissection relevant to the approach. CLINICAL PRESENTATION A 71-year-old female presented with progressive left-sided blurred vision, binocular diplopia, and mild proptosis. Contrast-enhanced brain MRI revealed a large heterogeneous enhanced inferomedial intraconal mass in the left orbital apex, mostly consistent with cavernous hemangioma. Gross total tumor removal was achieved through a modified 3-handed endoscopic endonasal extracapsular approach. The diplopia was resolved, and significant visual improvement was achieved. Computed tomography scan demonstrated complete tumor removal, and histological examination confirmed the diagnosis. CONCLUSION Endoscopic endonasal resection of large OACH can be feasibly performed by using a modified 3-handed extracapsular technique through the generous use of Q-tip swab applicators within the natural separation plane around the tumor capsule and a sequential traction-countertraction method. Subsequently, a gross total removal and optimal postoperative functional outcome are attainable through minimal rectus muscle fiber violation and intraconal fat manipulation.
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Affiliation(s)
- Mehdi Khaleghi
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Lucas P Carlstrom
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Claudio Andres Callejas
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Peter Kobalka
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
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Khaleghi M, Finger G, Wu KC, Munjal V, Ghalib L, Kobalka P, Blakaj D, Dibs K, Carrau R, Prevedello D. Successful treatment of medically and surgically refractory lymphocytic hypophysitis with fractionated stereotactic radiotherapy: a single-center experience and systematic literature review. Pituitary 2024; 27:213-229. [PMID: 38270722 DOI: 10.1007/s11102-023-01367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE To explore the potential role of focused radiotherapy in managing the lymphocytic hypophysitis (LH) refractory to medical therapy and surgery. METHOD A systematic literature review was conducted following PRISMA guidelines to identify the studies on radiation treatment for hypophysitis, along with the experience in our institution. RESULTS The study included eight patients, three from our institution and five from existing literature. The age at presentation ranged from 37 to 75 years old, with a median age of 58. The presenting symptoms involved headache in seven patients and diplopia in two patients. Pre-radiation visual field defects were noticed in four patients. All patients exhibited variable degrees of hypopituitarism before radiation, with oral corticosteroids being the initial medical treatment. Immunosuppressive therapy was attempted in two patients prior to radiation. Seven patients had a history of transsphenoidal surgery with a histologically confirmed LH. Three patients underwent stereotactic radiosurgery (SRS), while the remaining received FSRT, with a mean irradiation volume of 2.2 cm3. A single-session total dose of 12 -15 Gy was administered in the SRS group. In the FSRT group, doses ranged from 24 to 30 Gy with a median dose of 25 Gy, delivered in 2 Gy fractions. Four patients achieved a resolution of visual field defects, while another two patients demonstrated improvement in their associated focal neurologic deficits. No change in pre-existing endocrine status was shown after radiation, except in one patient. Clinical response was achieved in seven patients after a single course of radiation, while one patient required the second course. Six patients remained stable on low-dose glucocorticoid during at least a 12-month follow-up period, and one discontinued it entirely without experiencing relapse. Three patients demonstrated a complete radiologic response, while the remaining showed a partial radiologic response. CONCLUSIONS Focused radiation, including FSRT, can play a role in symptomatic relief, effective mass shrinkage, and minimizing radiation exposure to critical surrounding structures in patients with refractory LH. However, further research efforts are necessary to better clarify its effects and optimal dose planning.
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Affiliation(s)
- Mehdi Khaleghi
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Guilherme Finger
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kyle C Wu
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Vikas Munjal
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Luma Ghalib
- Department of Endocrinology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Peter Kobalka
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Dukagjin Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Khaled Dibs
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Prevedello
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Khaleghi M, Otto B, Carrau R, Abouammo MD, Prevedello DM. Customized ventral bony and dural opening in the transplanum/transtuberculum and transclival variants of extended endoscopic endonasal approach to suprasellar craniopharyngiomas: an approach-based stepwise cadaveric dissection and clinical applicability. Acta Neurochir (Wien) 2024; 166:146. [PMID: 38514521 DOI: 10.1007/s00701-024-06015-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Optimal initial exposure through an extended endoscopic endonasal approach (EEA) for suprasellar craniopharyngiomas ensures safe and unrestricted surgical access while avoiding overexposure, which may prolong the procedure and increase neurovascular adverse events. METHOD Here, the authors outline the surgical nuances of a customized bony and dural opening through the transplanum/transtuberculum and transclival variants of the extended EEA to suprasellar craniopharyngiomas based on the tumor-pituitary stalk relationship. A stepwise cadaveric dissection and intraoperative photographs relevant to the approaches are also provided. CONCLUSION Safe maximal resection of suprasellar craniopharyngiomas through extended EEAs can be feasibly and safely achieved by implementing of tailored ventral exposure.
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Affiliation(s)
- Mehdi Khaleghi
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Bradly Otto
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Moataz D Abouammo
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
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Khaleghi M, Vignolles-Jeong J, Otto B, Carrau R, Prevedello D. Intraoperative ultrasound-assisted endoscopic endonasal transclival marsupialization of an ectopic retrosellar Rathke's cleft cyst: A rare case illustration and systematic review of the literature. Clin Neurol Neurosurg 2024; 236:108050. [PMID: 37995620 DOI: 10.1016/j.clineuro.2023.108050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
Not every Rathke's cleft cyst (RCC) is confined within the sella between the posterior and anterior lobes of the pituitary gland. Intracranial ectopic RCCs are extremely rare, with only seven cases reported in the literature. In this study, the authors presented a rare case of a symptomatic ectopic retrosellar RCC posterior to the pituitary gland, causing extensive clival erosion. The surgical nuances of the wide marsupialization of the cyst through intraoperative ultrasound-assisted endoscopic endonasal transclival approach are described, and a systematic literature review of intracranial ectopic RCCs is conducted.
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Affiliation(s)
- Mehdi Khaleghi
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | | | - Bradley Otto
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Daniel Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
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Baliga S, Klamer B, Palmer J, Wells S, Gamez M, Jhawar S, Mitchell D, Grecula J, Kang S, Seim N, Ozer E, Agrawal A, VanKoevering K, Karivedu V, Bhateja P, Bonomi M, Old M, Rocco J, Carrau R, Blakaj D. Defining the Psychiatric and Financial Landscape of Mental and Substance Use Disorders in Head and Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Judd R, Zhang L, Zhao S, Rygalski C, Li M, Swendseid B, Blakaj D, Agrawal A, Ozer E, Carrau R, Teknos T, VanKoevering K, Rocco J, Old M, Seim N, Haring C, Kang S. Management of Positive Main Specimen Margin in Oral Tongue Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Velopharyngeal dysfunction (VPD) in head and neck cancer is frequently clinically reported, affecting both speech and swallowing function. This review sought to identify the tumor subsites and treatment modalities reported in association with VPD and summarize the current reporting methodology of VPD-related speech and swallowing outcomes in patients following head and neck cancer treatment. METHODS A literature search was conducted through December 2020 using electronic databases and a total of 15 studies were included in review. RESULTS Reported VPD was largely secondary to palate resections. Large variability in reporting methodology was noted with heavy reliance on speech-related perceptual measures and swallowing-related patient-reported outcomes over imaging and instrumental evaluations. CONCLUSIONS This review revealed inconsistencies in evaluating and reporting VPD, which likely translates into inconsistencies in clinical management. Further attention to VPD secondary to other head and neck malignancies would provide a broader perspective on VPD through head and neck cancer treatment.
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Affiliation(s)
- Veena Kallambettu
- Department of Speech and Hearing Science, Ringgold: 215745The Ohio State University, Columbus, OH, USA
- Ringgold: 12306The Ohio State University Wexner Medical Center- The James Comprehensive Cancer Center, Columbus, OH, USA
| | - Youkyung Bae
- Department of Speech and Hearing Science, Ringgold: 215745The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Ringgold: 12306The Ohio State University Wexner Medical Center- The James Comprehensive Cancer Center, Columbus, OH, USA
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Issa M, Klamer B, Karivedu V, Bhateja P, Laliotis GI, Dibs K, Mladkova N, Pan XJ, Old MO, Gamez M, Grecula JC, Jhawar SR, Mitchell DL, Baliga S, Carrau R, Rocco JW, Blakaj D, Bonomi MR. Use of cetuximab added to weekly chemotherapy to improve progression-free survival in patients with recurrent metastatic head and neck squamous cell carcinoma after progression on immune checkpoint inhibitors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6038 Background: Immune checkpoint inhibitors (ICI) are currently approved in the treatment of patients (pts) with recurrent-metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The majority of pts will progress on ICI. Little is known regarding the best treatment approach for this patient population. We previously showed that the combination of weekly carboplatin, paclitaxel and cetuximab was associated with reduced risk of grade 3/4 toxicities, which makes it an ideal regimen in this setting. Here; we report the outcomes of pts with R/M HNSCC who were treated with chemotherapy alone vs weekly chemotherapy plus cetuximab after progression on ICI. Methods: Between January 15th 2016 and April 9th 2020, 154 pts who progressed on ICI were analyzed. Among these pts, 64 had received subsequent systemic therapy and met the inclusion criteria. Progression Free Survival (PFS) was defined as the time elapsed between initiation of subsequent chemotherapy and tumor progression or death. Overall Survival (OS) was defined as the time elapsed between initiation of subsequent chemotherapy to death. Descriptive statistics and Cox regression were used to explore study variables. Results: 64 pts received subsequent chemotherapy after progression on ICI. 28 pts (44%) received a combination of weekly chemotherapy plus cetuximab. This regimen included carboplatin AUC 1.5, paclitaxel 45 mg/m2, and cetuximab loading dose of 400mg/m2 followed by weekly dose of 250 mg/m2. 36 pts (56%) received chemotherapy alone without cetuximab. These regimens included capecitabine, afatinib, and gemcitabine, among others. Sex: 51 males (80%), 13 females (20%), age (median): 61 (IQR: 53-66), tumor site: oropharynx 32 (50%), oral cavity 11 (17%), larynx 8 (12%), other sites 13 (21%). P16 status: negative 36 (56%), positive 28 (44%). Prior ICI drug: pembrolizumab 34 (53%), nivolumab 26 (41%), ipilimumab + nivolumab 4 (6%). Median follow up: 9 months (IQR: 5-13). Overall response rate: weekly chemotherapy plus cetuximab 32%, chemotherapy alone 22% (p = 0.4). Pts who received chemotherapy alone had a median PFS of 3.2 months (CI: 2-5) vs 5.6 months (CI: 4.3-10.1) in the weekly chemotherapy plus cetuximab group. After adjusting for p16 status and prior ICI drug, PFS was improved in the group that received weekly chemotherapy plus cetuximab vs. chemotherapy alone (HR: 0.52; CI: 0.28-0.98; p = 0.042). Median OS was 10 months (CI: 8.5-NR) in the weekly chemotherapy plus cetuximab group vs 8.7 months (CI: 5.7-13.8) in the chemotherapy alone group (HR: 0.84; CI: 0.4-1.8; p = 0.8). Conclusions: Pts with R/M HNSCC who progressed on ICI experience longer PFS with the addition of cetuximab to weekly chemotherapy. Further investigation in a larger cohort of pts is needed to fully assess the impact on survival for this treatment combination.
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Affiliation(s)
- Majd Issa
- Ohio State University-James Cancer Hospital Solove Research Institute, Columbus, OH
| | - Brett Klamer
- Center for Bostatistics, OSU Wexner Medical Center, Columbus, OH
| | - Vidhya Karivedu
- Division of Medical Oncology, Ohio State University, Columbus, OH
| | | | | | - Khaled Dibs
- The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Xueliang Jeff Pan
- Center for Biostatistics, The Ohio State University Comprehensive Cancer Center, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH
| | - Matthew O. Old
- Ohio State University-Arthur James Cancer Hospital, Columbus, OH
| | - Mauricio Gamez
- Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Sachin R Jhawar
- The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Sujith Baliga
- Ohio State University-James Cancer Hospital Solove Research Institute, Columbus, OH
| | - Ricardo Carrau
- The James Cancer Hospital and Solove Research Institute, Columbus, OH
| | | | - Dukagjin Blakaj
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
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Laliotis GI, Issa M, Klamer B, Karivedu V, Bhateja P, Dibs K, Mladkova N, Pan XJ, Old MO, Gamez M, Grecula JC, Jhawar SR, Mitchell DL, Baliga S, Carrau R, Rocco JW, Blakaj D, Bonomi MR. Expansion cohort validation of a clinical predictive model for head and neck cancer survival in patients treated with immune checkpoint inhibitors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6030 Background: Immune checkpoint inhibitors (ICI) therapy is approved for patients (pts) with recurrent-metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The majority of pts will die within two years of diagnosis. We have shown that pretreatment clinical characteristics may predict overall survival (OS). Here, we expand our analysis to a total of 201 pts. Methods: Between January 15,2016 and April 9, 2020, 201 pts with R/M HNSCC were treated with ICI as first, second line and beyond. Data on p16 status, hemoglobin (Hb), albumin, lactate dehydrogenase (LDH), neutrophil, platelet and lymphocyte count was recorded initially. OS was defined from the start of ICI to death. Progression Free Survival (PFS) was defined from the start of ICI to disease progression (PD) or death. A nomogram was created using the rms package to generate individualized survival prediction. Results: 201 pts were analyzed, sex: 154 male (77%), 47 female (23%), median age 61 (IQR: 55-68). ICI drug: pembrolizumab 100 (50%), nivolumab 91 (45%), ipilimumab+nivolumab 10 (5%). Line of therapy: First: 98 (49%), second and beyond: 103 (51%). Tumor site: oropharynx 84 (42%), oral cavity 45 (22%), others 72 (36%). p16 status: negative 132 (66%), positive 69 (34%). Laboratory values: Median neutrophil count: 4.58 (IQR: 3.43-6.47), Median lymphocyte count: 0.69 (IQR: 0.47-1.08), Median Platelet count: 229 (IQR: 187-300), hemoglobin (Hb) normal/low 101/100 (50%/50%), albumin: normal/low 156/45 (78%/22%), LDH: normal/high 124/77 (62%/38%). Overall response rate: 36 (18%). Median OS: 12 months (CI: 9.4-14.8), median PFS: 4 months (CI: 3.5-5.7). The variables associated with OS were neutrophil count (high) [HR 1.28 (1.08 – 1.51), p=0.004], lymphocyte count (high) [HR 0.75 (0.60 – 0.95), p=0.015], albumin (low) [HR 2.06 (1.37 – 3.10), p<0.001], hemoglobin (low) [HR 1.64 (1.14 – 2.35), p=0.007], LDH (high) [HR 1.78 (1.23 – 2.56), p=0.002] and p16 status (positive) [HR 0.58 (0.39-0.87), p=0.009]. Using the prognostic index of the chosen model, we stratified patients into three risk groups at the 33rd and 66th percentile. Median OS in the good risk group was 24 months (CI: 18.5-NR), average risk group 13.8 months (CI: 11-20), poor risk group 2.3 months (CI: 1.7-4.4). The discrimination of the model after internal validation was c-index of 0.72. Conclusions: A small percentage of R/M HNSCC pts treated with ICI have good long-term survival outcomes. In a larger cohort, we internally validated the utilization of a simple, inexpensive and widely accessible nomogram based on clinical and laboratory variables which can predict OS in this patient population.
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Affiliation(s)
| | - Majd Issa
- Ohio State University-James Cancer Hospital Solove Research Institute, Columbus, OH
| | - Brett Klamer
- Center for Bostatistics, OSU Wexner Medical Center, Columbus, OH
| | - Vidhya Karivedu
- Division of Medical Oncology, Ohio State University, Columbus, OH
| | | | - Khaled Dibs
- The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Xueliang Jeff Pan
- Center for Biostatistics, The Ohio State University Comprehensive Cancer Center, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH
| | - Matthew O. Old
- Ohio State University-Arthur James Cancer Hospital, Columbus, OH
| | - Mauricio Gamez
- Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Sachin R Jhawar
- The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Sujith Baliga
- Ohio State University-James Cancer Hospital Solove Research Institute, Columbus, OH
| | | | | | - Dukagjin Blakaj
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
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Villalonga JF, Solari D, Cavallo LM, Cappabianca P, Prevedello DM, Carrau R, Martinez-Perez R, Hardesty D, Fuchssteiner C, Saenz A, Abbritti RV, Valencia-Ramos C, Kaen A, Bernat AL, Cardenas E, Hirtler L, Gomez-Amador JL, Liu J, Froelich S, Cervio A, Campero A. The sellar barrier on preoperative imaging predicts intraoperative cerebrospinal fluid leak: a prospective multicenter cohort study. Pituitary 2021; 24:27-37. [PMID: 32918661 DOI: 10.1007/s11102-020-01082-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The type of sellar barrier observed between a pituitary tumor and cerebrospinal fluid (CSF) on preoperative magnetic resonance imaging (MRI) may predict intraoperative CSF leak during endonasal pituitary surgery. This is the first multicentric prospective cohort trial to study the sellar barrier concept and CSF leak rate during endoscopic pituitary surgery. METHODS This multi-center, international study enrolled patients operated for pituitary adenomas via fully endoscopic endonasal surgery over a period of 4 months. The independent variable was the subtype of sellar barrier observed on preoperative MRI (strong, mixed or weak); the dependent variable was the presence of an intraoperative CSF leak. The primary goal was to determine the association between a particular type of sellar barrier and the risk of intraoperative CSF leak. Appropriate statistical methods were then applied for data analysis. RESULTS Over the study period, 310 patients underwent endoscopic endonasal surgery for pituitary tumor. Preoperative imaging revealed a weak sellar barrier in 73 (23.55%), a mixed sellar barrier in 75 (24.19%), and a strong sellar barrier in 162 (52.26%) patients. The overall rate of intraoperative CSF leak among all patients was 69 (22.26%). A strong sellar-type barrier was associated with significantly reduced rate of intraoperative CSF leak (RR = 0.08; 95% CI 0.03-0.19; p < 0.0001), while a weak sellar barrier associated with higher rates of CSF leak (RR = 8.54; 95% CI 5.4-13.5; p < 0.0001). CONCLUSIONS The preoperative MRI of pituitary patients can suggest intraoperative CSF leak rates, utilizing the concept of the sellar barrier. Patients with a weak sellar barrier carry a higher risk for an intraoperative CSF leak, whereas a strong sellar barrier on MRI seems to mitigate intraoperative CSF leak. We propose that preoperatively assessment of the sellar barrier can prepare surgeons for intraoperative CSF leak repair.
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Affiliation(s)
- Juan F Villalonga
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Lamadrid 875, San Miguel de Tucumán, Tucumán, Argentina.
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Luigi M Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Paolo Cappabianca
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Daniel M Prevedello
- Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Rafael Martinez-Perez
- Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Douglas Hardesty
- Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Christoph Fuchssteiner
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Amparo Saenz
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Lamadrid 875, San Miguel de Tucumán, Tucumán, Argentina
| | | | | | - Ariel Kaen
- Hospital Virgen del Rocío, Sevilla, Spain
| | - Anne-Laure Bernat
- Lariboisière University Hospital - Assistance Publique, Paris, France
| | | | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - James Liu
- Rutgers New Jersey Medical School, Newark, NY, USA
| | | | | | - Alvaro Campero
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Lamadrid 875, San Miguel de Tucumán, Tucumán, Argentina
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Katzir M, Hoang N, Bourekas E, Carrau R, Mendel E. Stereotactic CT image guidance and biplanar fluoroscopy for transoral C2 vertebroplasty and direct anterolateral subaxial vertebroplasty: a surgical technique note on access to the axial and subaxial spine. Acta Neurochir (Wien) 2020; 162:2533-2536. [PMID: 32572579 DOI: 10.1007/s00701-020-04452-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Metastatic cervical spine disease can cause compression fractures, cervical spine instability, and pain. Vertebroplasty can stabilize a fracture, reduce the pain associated with a compression fracture, prevent or stop the progression of a fracture, thus avoiding cervical spine fixation, and decreased mobility. Transoral C2 vertebroplasty is less invasive than open fusion surgery, but it poses its own risk of infection and cement leak in this highly sensitive area. METHODS The image guidance setup consisted of the Stryker NAV3i navigation system, Stryker CranialMask tracker, and the CranialMap 3.0 software combined with biplanar fluoroscopy. RESULTS The patient's neck pain has completely resolved immediately after the surgery. There were no complications. CONCLUSION Quality of life preservation is paramount in the management of metastatic spine disease. Vertebroplasty of osteolytic lesions can both relieve pain and restore stability, thus avoiding permanent stiff cervical collar, halo vest, or upfront occipitocervical fusion. With the increasing availability of surgical navigation systems, its use combined with biplanar fluoroscopy for performing transoral C2 vertebroplasty seems to be an adequate treatment in selected cases for pain relief, stabilization, and maintaining quality of life in the complex cancer population with C2 pathological fractures. The article describes as well vertebroplasty of the subaxial spine through a conventional anterior approach which again seems to be adequate in the treatment of spinal pathological fractures. Graphical abstract.
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Affiliation(s)
- Miki Katzir
- Department of Neurological Surgery, The Wexner Medical Center, James Cancer Center, The Ohio State University, 410 W 10th Ave, 1014 N Doan Hall, Columbus, OH, 43210-1267, USA.
| | - Nguyen Hoang
- Department of Neurological Surgery, The Wexner Medical Center, James Cancer Center, The Ohio State University, 410 W 10th Ave, 1014 N Doan Hall, Columbus, OH, 43210-1267, USA
| | - Eric Bourekas
- Department of Radiology, The Wexner Medical Center, James Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology, The Wexner Medical Center, James Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Ehud Mendel
- Department of Neurological Surgery, The Wexner Medical Center, James Cancer Center, The Ohio State University, 410 W 10th Ave, 1014 N Doan Hall, Columbus, OH, 43210-1267, USA
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13
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Patel KB, Martin D, Zhao S, Kumar B, Carrau R, Ozer E, Agrawal A, Kang S, Rocco JW, Schuller D, Teknos T, Brock G, Old M. Impact of age and comorbidity on survival among patients with oral cavity squamous cell carcinoma. Head Neck 2020; 43:268-277. [PMID: 32996249 DOI: 10.1002/hed.26487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 08/24/2020] [Accepted: 09/21/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To identify predictors of overall survival (OS) and to stratify patients according to significant prognostic variables. METHODS A retrospective study of 274 consecutive patients with primary Oral Cavity Squamous Cell Carcinoma. Kaplan-Meier, Cox proportional hazard models, and recursive partitioning analysis (RPA) were used for analysis of OS. These results were further validated using National Cancer Database cohort of 21 895 patients. RESULTS Median OS was 3.65 years. T-classification and N-classification, alcoholic beverages/week, age, and adjuvant treatment were significant predictors of OS. RPA identified high-risk subpopulations: N0-1 patients with CCI ≥ 4.5 and N2-3 patients ordered by those not receiving adjuvant treatment, those with T3-4 disease despite adjuvant therapy, and those having T1-2 disease with adjuvant therapy. CONCLUSIONS This study utilized significant prognostic indicators and RPA to highlight the importance of age, N-classification, T-classification, comorbidity, and adjuvant therapy in conjunction with American Joint Committee on Cancer staging to improve preoperative counseling.
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Affiliation(s)
- Krupal B Patel
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Daniel Martin
- School of Medicine & Dentistry, University of Rochester, Rochester, New York, USA
| | - Songzhu Zhao
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Stephen Kang
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - James W Rocco
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - David Schuller
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
| | - Theodoros Teknos
- Department of Otolaryngology-Head and Neck Surgery, Case Western University, Cleveland, Ohio, USA
| | - Guy Brock
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA
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14
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Ackall FY, Issa K, Barak I, Teitelbaum J, Jang DW, Jung SH, Goldstein B, Carrau R, Abi Hachem R. Survival Outcomes in Sinonasal Poorly Differentiated Squamous Cell Carcinoma. Laryngoscope 2020; 131:E1040-E1048. [PMID: 32959912 DOI: 10.1002/lary.29090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/11/2020] [Accepted: 08/22/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Sinonasal squamous cell carcinoma (SCC) is rare with no consensus on treatment regimen. Our goal is to analyze treatment outcomes in poorly differentiated SCC (PDSCC) using a large national database. STUDY DESIGN Retrospective database study. METHODS The National Cancer Database was queried for sinonasal invasive SCC, grade 3 (poorly differentiated) from 2004 to 2014. Patient demographics and tumor and treatment characteristics were tabulated. Kaplan-Meier (KM) analysis was performed to compare overall survival (OS) between histology subtype and primary site. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen on OS. RESULTS A total of 1,074 patients were identified. The maxillary sinus was the most common site (45%). T4 tumors were observed in 50% of patients, with most patients treated at high-volume facilities (77%). In KM analysis, spindle cell SCC histological subtype, primary tumors of the maxillary sinus, and poorly differentiated grade had worse OS. In our Cox-PH model, higher T stage and age were associated with worse OS. Those treated at a high-volume facility and those who underwent surgical resection followed by adjuvant radiation had improved OS. Chemotherapy within the treatment regimen did not confer survival benefit except in surgical patients when positive margins were present, and surgery with adjuvant chemoradiation trended toward improved survival. CONCLUSIONS Sinonasal PDSCC appears to be best treated at high-volume centers with surgical resection followed by adjuvant radiation. Poorly differentiated grade has worse OS compared to more differentiated tumors. Chemotherapy along with adjuvant radiation may have a role in patients with positive surgical margins. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1040-E1048, 2021.
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Affiliation(s)
- Feras Y Ackall
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Ian Barak
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, U.S.A
| | - Jordan Teitelbaum
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - David W Jang
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Sin-H Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, U.S.A
| | - Bradley Goldstein
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio, U.S.A
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A
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15
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Issa M, Schultz T, Xu M, Bhateja P, Karivedu V, Dibs K, Old M, Kang S, Gamez M, Grecula J, Jhawar S, Mitchell D, Seim N, Agrawal A, Ozer E, Baliga S, Carrau R, Rocco J, Blakaj D, Bonomi M. 948P Pre-treatment characteristics and long-term outcomes of recurrent-metastatic head and neck cancer patients treated with immune checkpoint inhibitors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Palmer JD, Gamez ME, Ranta K, Ruiz-Garcia H, Peterson JL, Blakaj DM, Prevedello D, Carrau R, Mahajan A, Chaichana KL, Trifiletti DM. Radiation therapy strategies for skull-base malignancies. J Neurooncol 2020; 150:445-462. [PMID: 32785868 DOI: 10.1007/s11060-020-03569-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The management of skull base malignancies continues to evolve with improvements in surgical technique, advances in radiation delivery and novel systemic agents. METHODS In this review, we aim to discuss in detail the management of common skull base pathologies which typically require multimodality therapy, focusing on the radiotherapeutic aspects of care. RESULTS Technological advances in the administration of radiation therapy have led to a wide variety of different treatment strategies for the treatment of skull base malignances, with outcomes summarized herein. CONCLUSION Radiation treatment plays a key and critical role in the management of patients with skull base tumors. Recent advancements continue to improve the risk/benefit ratio for radiotherapy in this setting.
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Affiliation(s)
- J D Palmer
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M E Gamez
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - K Ranta
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - H Ruiz-Garcia
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA
| | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA.,Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - D M Blakaj
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Prevedello
- Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Otolaryngology - Head and Neck Surgery at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R Carrau
- Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Otolaryngology - Head and Neck Surgery at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - K L Chaichana
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - D M Trifiletti
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA. .,Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
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17
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Bonomi M, Bhateja P, Issa M, Klamer B, Pan X, Blakaj A, Karivedu V, Mousa L, Mitchell D, Gamez M, Kang S, Seim NB, Old M, Carrau R, Rocco J, Blakaj D. A predictive survival model for patients with head and neck squamous cell carcinoma treated with immune check point inhibitors. Oral Oncol 2020; 110:104900. [PMID: 32702630 DOI: 10.1016/j.oraloncology.2020.104900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND ICIs have expanded treatment options for HNSCC. A minority of the patients respond to these expensive treatments. PATIENTS AND METHODS This is a single institutional retrospective review on 121 unresectable or metastatic HNSCC patients treated with ICIs. We predicted that inflammatory markers available through routine blood work, in addition to clinical characteristics may divide patients into groups more or less likely to respond to these agents. Here we develop and internally validate our nomogram to predict survival in patients treated with ICIs.
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Affiliation(s)
- M Bonomi
- Division of Medical Oncology, Ohio State University, Columbus, United States.
| | - P Bhateja
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - M Issa
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - B Klamer
- Department of Biomedical Informatics, Ohio State University, Columbus, United States
| | - X Pan
- Department of Biomedical Informatics, Ohio State University, Columbus, United States
| | - A Blakaj
- Division of Radiation Oncology, Yale University, New Haven, United States
| | - V Karivedu
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - L Mousa
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - D Mitchell
- Division of Radiation Oncology, Ohio State University, Columbus, United States
| | - M Gamez
- Division of Radiation Oncology, Ohio State University, Columbus, United States
| | - S Kang
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - Nolan B Seim
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - M Old
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - R Carrau
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - J Rocco
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - D Blakaj
- Division of Radiation Oncology, Ohio State University, Columbus, United States
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18
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Wolfe AR, Blakaj D, London N, Blakaj A, Klamer B, Pan J, Wakely P, Prevedello L, Bonomi M, Bhatt A, Raval R, Palmer J, Prevedello D, Gamez M, Carrau R. Clinical Outcomes and Multidisciplinary Patterns of Failure for Olfactory Neuroblastoma: The Ohio State Experience. J Neurol Surg B Skull Base 2020; 81:287-294. [PMID: 32500004 PMCID: PMC7253300 DOI: 10.1055/s-0039-1692479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/08/2019] [Indexed: 10/26/2022] Open
Abstract
Purpose Olfactory neuroblastoma (ONB) is a rare head and neck cancer believed to be originated from neural crest cells of the olfactory membrane located in the roof of the nasal fossa. This study evaluates clinical outcomes and failure patterns in ONB patients of those patients treated with surgical resection at a high-volume tertiary cancer center. Methods and Materials Thirty-nine ONB patients who underwent surgical resection at our institution from 1996 to 2017 were retrospectively identified. Univariate, multivariate, and survival analysis were calculated using Cox regression analysis and Kaplan-Meier log-rank. Results Median follow-up time was 59 months (range: 5.2-236 months). The median overall survival (OS) and disease-free survival (DFS) for the entire cohort were 15 and 7.6 years, respectively. The 5-year cumulative OS and DFS were 83 and 72%, respectively. The 5-year OS for low Hyams grade (LHG) versus high Hyams grade (HHG) was 95 versus 61% ( p = 0.041). LHG was found in 66% of the early Kadish stage patients compared with 28% in the advanced Kadish stage patients ( p = 0.057). On multivariate analysis, HHG and positive node status predicted for worse OS and only HHG predicted for worse DFS. Of note, five patients (all Kadish stage A) who received surgical resection alone had no observed deaths or recurrences with a median follow-up of 44 months (range: 5-235 months). Conclusion In this retrospective cohort, patients with positive nodes or HHG have significantly worse clinical outcomes. Future studies should explore treatment intensification for HHG or positive nodes.
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Affiliation(s)
- Adam R. Wolfe
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Dukagjin Blakaj
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Nyall London
- Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
| | - Adriana Blakaj
- Department of Radiation Oncology, Yale University, New Haven, Connecticut, United States
| | - Brett Klamer
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Jeff Pan
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Paul Wakely
- Department of Pathology, The Ohio State University, Columbus, Ohio, United States
| | - Luciano Prevedello
- Department of Radiology, The Ohio State University, Columbus, Ohio, United States
| | - Marcelo Bonomi
- Department of Medical Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Aashish Bhatt
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Raju Raval
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Joshua Palmer
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
| | - Mauricio Gamez
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
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19
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Wolfe AR, Blakaj D, London N, Blakaj A, Klamer B, Pan J, Wakely P, Prevedello L, Bonomi M, Bhatt A, Raval R, Palmer J, Prevedello D, Gamez M, Carrau R. Erratum: Clinical Outcomes and Multidisciplinary Patterns of Failure for Olfactory Neuroblastoma: The Ohio State Experience. J Neurol Surg B Skull Base 2020; 81:e1. [PMID: 37745951 PMCID: PMC10515300 DOI: 10.1055/s-0039-1694000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
[This corrects the article DOI: 10.1055/s-0039-1692479.].
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Affiliation(s)
- Adam R. Wolfe
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Dukagjin Blakaj
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Nyall London
- Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
| | - Adriana Blakaj
- Department of Radiation Oncology, Yale University, New Haven, Connecticut, United States
| | - Brett Klamer
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Jeff Pan
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Paul Wakely
- Department of Pathology, The Ohio State University, Columbus, Ohio, United States
| | - Luciana Prevedello
- Department of Radiology, The Ohio State University, Columbus, Ohio, United States
| | - Marcelo Bonomi
- Department of Medical Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Aashish Bhatt
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Raju Raval
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Joshua Palmer
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
| | - Maurico Gamez
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
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20
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Mladkova N, Olausson A, Gamez M, Grecula J, Miller E, Jhawar S, Bhateja P, Old M, Agrawal A, Ozer E, Carrau R, Kang S, Seim N, Rocco J, Bonomi M, Blakaj D. Body-Mass Index (BMI) and early stage as predictors of papillomavirus infection in H&N cancers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Densky J, Eskander A, Kang S, Chan J, Tweel B, Sitapara J, Ozer E, Agrawal A, Carrau R, Rocco J, Teknos TN, Old M. Risk Factors Associated With Postoperative Delirium in Patients Undergoing Head and Neck Free Flap Reconstruction. JAMA Otolaryngol Head Neck Surg 2020; 145:216-221. [PMID: 30605208 DOI: 10.1001/jamaoto.2018.3820] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Importance Postoperative delirium (POD) is associated with an increased rate of adverse events, higher health care costs, and longer hospital stays. At present, limited data are available regarding the risk factors for developing POD in patients undergoing head and neck free flap reconstruction. Identification of patients at high risk of developing POD will allow implementation of risk-mitigation strategies. Objective To determine the frequency of and risk factors associated with POD in patients undergoing free flap reconstruction secondary to head and neck disease. Design, Setting, and Participants This retrospective cohort study included 515 patients undergoing free flap reconstruction from January 1, 2006, through December 31, 2012, at the James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Care Center, a tertiary care cancer hospital. Preoperative, intraoperative, and postoperative data were collected retrospectively. Data from January 1, 2006, through December 31, 2012, were analyzed, and the final date of data analysis was January 8, 2018. Interventions Head and neck free flap reconstruction. Main Outcomes and Measures The primary outcome was the development of POD as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Univariable and multivariable logistic regression were used to identify risk factors associated with POD. Results Five hundred fifteen patients underwent free flap reconstruction during the study period (66.2% male; mean [SD] age, 60.1 [12.8] years). Of these, 56 patients (10.9%) developed POD. On multivariable analysis, risk factors associated with POD included increased age (odds ratio [OR], 1.06; 95% CI, 1.02-1.11), male sex (OR, 5.02; 95% CI, 1.47-17.20), increased operative time (OR for each 1-minute increase, 1.004 [95% CI, 1.001-1.006]; OR for each 1-hour increase, 1.26 [95% CI, 1.08-1.46]), advanced nodal disease (OR, 3.00; 95% CI, 1.39-6.46), and tobacco use (OR, 7.23; 95% CI, 1.43-36.60). Preoperative abstinence from alcohol was identified as a protective factor (OR, 0.24; 95% CI, 0.12-0.51). Conclusions and Relevance This study identified variables associated with a higher risk of developing POD. Although many of these risk factors are nonmodifiable, they provide a target population for quality improvement initiatives. Furthermore, preoperative alcohol abstinence may be useful in preventing POD.
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Affiliation(s)
- Jaron Densky
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Antoine Eskander
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, Ontario, Canada
| | - Stephen Kang
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Jon Chan
- Department of Otolaryngology-Head & Neck Surgery, Virginia Commonwealth University, Richmond
| | - Ben Tweel
- Department of Otolaryngology-Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jigar Sitapara
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Enver Ozer
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Amit Agrawal
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - James Rocco
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Ted N Teknos
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
| | - Matthew Old
- Department of Otolaryngology-Head & Neck Surgery, Division of Head & Neck Oncology, The Ohio State University, James Cancer Hospital and Solove Research Institute, Columbus
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22
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Ali M, Marin J, Prevedello D, Otto B, Cho R, Carrau R. Erratum: Inferolateral Transorbital Approach to the Petrous Apex. An Adjunctive Approach to the EEA. Skull Base Surg 2020; 81:e1. [DOI: 10.1055/s-0040-1708047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Moustafa Ali
- Ohio State University, Columbus, Ohio, United States
- Assiut University, Egypt
| | | | | | - Bradley Otto
- Ohio State University, Columbus, Ohio, United States
| | - Ray Cho
- Ohio State University, Columbus, Ohio, United States
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23
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Walz PC, Drapeau A, Shaikhouni A, Eide J, Rugino AJ, Mohyeldin A, Carrau R, Prevedello D. Pediatric pituitary adenomas. Childs Nerv Syst 2019; 35:2107-2118. [PMID: 31302729 DOI: 10.1007/s00381-019-04293-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pediatric pituitary adenomas are a rare medical entity that makes up a small portion of intracranial tumors in children and adolescents. Although benign, the majority of these lesions are secreting functional tumors with the potential for physiological sequela that can profoundly affect a child's development. FOCUS OF REVIEW In this review, we discuss the medical and surgical management of these tumors with a focus on clinical presentation, diagnostic identification, surgical approach, and associated adjuvant therapies. We will also discuss our current treatment paradigm using endoscopic, open, and combined approaches to treat these tumors. The management of pituitary tumors requires a multidisciplinary team of surgeons, endocrinologists, and neuroanesthesiologists as well as neurocritical care specialists to deliver comprehensive care.
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Affiliation(s)
- Patrick C Walz
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. .,Department of Pediatric Otolaryngology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Annie Drapeau
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Pediatric Neurosurgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Ammar Shaikhouni
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Pediatric Neurosurgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jacob Eide
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Ahmed Mohyeldin
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ricardo Carrau
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Pediatric Otolaryngology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.,Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Prevedello
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Pediatric Neurosurgery, Nationwide Children's Hospital, Columbus, OH, USA
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Mousa L, Issa M, Klamer B, Pan J, Old M, Kang S, Agrawal A, Ozer E, Carrau R, Bhateja P, Rupert R, Jhawar S, Mitchell D, Gamez M, Rocco J, Blakaj D, Bonomi M. A nomogram based prognostic score to predict overall survival (OS) in recurrent-metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts) treated with immune checkpoint inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Issa M, Mousa L, Blakaj D, Klamer B, Pan J, Old M, Kang S, Rupert R, Mitchell D, Ozer E, Agrawal A, Bhateja P, Gamez M, Miller E, Jhawar S, Carrau R, Rocco J, Bonomi M. Treatment outcomes of head and neck cancer patients 70 years and older receiving different chemo-radiation combinations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Sethia R, Allarakhia Z, Puram S, Kang S, Ozer E, Agrawal A, Carrau R, Rocco J, Old M. Free flap salvage from venous thrombosis by creation of a venocutaneous fistula: Case report and review of the literature. Head Neck 2019; 41:E159-E162. [PMID: 31512798 DOI: 10.1002/hed.25957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/08/2019] [Accepted: 08/26/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Venous congestion is the most frequently reported complication of free flap tissue transfer in head and neck patient with cancer. Numerous methods are utilized and prompt correction is necessary to prevent flap failure. METHODS A 77-year-old woman underwent oral cavity resection and neck dissection for squamous cell carcinoma followed by radial forearm free flap for reconstruction. Three days later, the flap became congested and surgical exploration revealed extensive venous thrombosis throughout the free flap venous system and internal jugular vein. The flap vein was evacuated and flowing, and a venocutaneous fistula was created thereafter. RESULTS Venocutaneous fistula resulted in flap decongestion and successful salvage. The patient was discharged from the hospital with no further flap or surgical complications. CONCLUSION When anatomical revision of the venous anastomosis is not feasible in a venous-congested free flap, the creation of a venocutaneous fistula should be considered as a viable option for salvage.
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Affiliation(s)
- Rishabh Sethia
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | - Sidharth Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Stephen Kang
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - James Rocco
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.,Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio
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27
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Griffiths CF, Barkhoudarian G, Cutler A, Duong HT, Karimi K, Doyle O, Carrau R, Kelly DF. Analysis of Olfaction after Bilateral Nasoseptal Rescue Flap Transsphenoidal Approach with Olfactory Mucosal Preservation. Otolaryngol Head Neck Surg 2019; 161:881-889. [PMID: 31331243 DOI: 10.1177/0194599819861340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To ascertain the impact of septal olfactory strip preservation and bilateral rescue flap elevation on the incidence of olfactory dysfunction. STUDY DESIGN Case series with chart review of patients undergoing endoscopic endonasal skull base surgery (2012-2014). SETTING Providence Saint John's Health Center and John Wayne Cancer Institute. SUBJECTS AND METHODS The incidences of postoperative epistaxis, hyposmia, and anosmia were analyzed using the Brief Smell Identification Test (B-SIT), which was completed in 110 of the 165 patients. RESULTS Seventy-eight patients required extended approaches. Bilateral nasoseptal rescue flaps were elevated in 144 patients (87.3%) and pedicled nasoseptal or middle turbinate flaps in 21 patients (12.7%). The neurovascular pedicles were preserved in all patients, and there were no episodes of postoperative arterial epistaxis. Normal olfaction was noted in 95 patients (86%), with new hyposmia noted in 5 patients (5.5%). Within the rescue flap cohort, new hyposmia occurred in 6.3% (P < .01) of patients, balanced by improvement of olfaction in 43% of patients with preoperative dysfunction (overall pre- and postoperative olfactory function: 85% vs 86%). Patients with pedicled nasoseptal flaps did not have new hyposmia, with a net improvement of olfaction (71% vs 86%, P = .07). No patients experienced new anosmia. There was no difference between flap type within either subgroup. CONCLUSIONS Superior olfactory strip preservation during elevation of reconstructive flaps preserves olfactory function and maintains adequate surgical exposure. In addition, rescue flaps have significantly diminished the rate of arterial postoperative epistaxis while maintaining the ability to harvest nasoseptal flaps for future reconstruction.
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Affiliation(s)
- Chester F Griffiths
- Pacific Neuroscience Institute & Pituitary Disorders Program, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California, USA
| | - Garni Barkhoudarian
- Pacific Neuroscience Institute & Pituitary Disorders Program, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California, USA
| | - Aaron Cutler
- Inland Neurosurgery Institute, Pomona, California, USA
| | - Huy T Duong
- University of California, Davis Medical School, Davis, California and The Kaiser Permanente Medical Group, Sacramento, California, USA
| | - Kian Karimi
- Pacific Eye and Ear Specialists, Los Angeles, California, USA
| | - Olivia Doyle
- Pacific Eye and Ear Specialists, Los Angeles, California, USA
| | - Ricardo Carrau
- Comprehensive Skull Base Surgery Program, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Daniel F Kelly
- Pacific Neuroscience Institute & Pituitary Disorders Program, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California, USA
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28
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Geltzeiler M, Carrau R, Chandra R, Palmer J, Schlosser R, Smith T, Wise S, Woodworth B. Management of spontaneous cerebrospinal fluid leaks. Int Forum Allergy Rhinol 2019; 9:330-331. [DOI: 10.1002/alr.22318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery; Oregon Health & Science University; Portland OR
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Neck Surgery; The Ohio State University; Columbus OH
| | - Rakesh Chandra
- Department of Otolaryngology-Head and Neck Surgery; Vanderbilt University; Nashville TN
| | - James Palmer
- Department of Otolaryngology-Head and Neck Surgery; University of Pennsylvania; Philadelphia PA
| | - Rodney Schlosser
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Timothy Smith
- Department of Otolaryngology-Head and Neck Surgery; Oregon Health & Science University; Portland OR
| | - Sarah Wise
- Department of Otolaryngology-Head and Neck Surgery; Emory University; Atlanta GA
| | - Bradford Woodworth
- Department of Otolaryngology-Head and Neck Surgery; University of Alabama; Birmingham AL
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29
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Kaka AS, Zhao S, Ozer E, Agrawal A, Kang S, Rocco J, Carrau R, Teknos T, Clapp JD, Weed H, Old MO. Comparison of Clinical Outcomes Following Head and Neck Surgery Among Patients Who Contract to Abstain From Alcohol vs Patients Who Abuse Alcohol. JAMA Otolaryngol Head Neck Surg 2019; 143:1181-1186. [PMID: 28447103 DOI: 10.1001/jamaoto.2017.0553] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Azeem S Kaka
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - Songzhu Zhao
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus
| | - Enver Ozer
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - Amit Agrawal
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - Stephen Kang
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - James Rocco
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - Ricardo Carrau
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - Theodoros Teknos
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
| | - John D Clapp
- The Ohio State University College of Social Work, Columbus
| | - Harrison Weed
- Division of General Medicine, Department of Internal Medicine, Wexner Medical Center at The Ohio State University, Columbus
| | - Matthew O Old
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus.,Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus
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30
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Teknos TN, Grecula J, Agrawal A, Old MO, Ozer E, Carrau R, Kang S, Rocco J, Blakaj D, Diavolitsis V, Kumar B, Kumar P, Pan Q, Palettas M, Wei L, Baiocchi R, Savvides P. A phase 1 trial of Vorinostat in combination with concurrent chemoradiation therapy in the treatment of advanced staged head and neck squamous cell carcinoma. Invest New Drugs 2018; 37:702-710. [PMID: 30569244 DOI: 10.1007/s10637-018-0696-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/12/2018] [Indexed: 12/12/2022]
Abstract
Purpose Vorinostat is a potent HDAC inhibitor that sensitizes head and neck squamous cell carcinoma (HNSCC) to cytotoxic therapy while sparing normal epithelium. The primary objective of this Phase I study was to determine the maximally tolerated dose (MTD) and safety of Vorinostat in combination with standard chemoradiation therapy treatment in HNSCC. Patients and Methods Eligible patients had pathologically confirmed Stage III, IVa, IVb HNSCC, that was unresectable or borderline resectable involving the larynx, hypopharynx, nasopharynx, and oropharynx. Vorinostat was administered at the assigned dosage level (100-400 mg, three times weekly) in a standard 3 + 3 dose escalation design. Vorinostat therapy began 1 week prior to initiation of standard, concurrent chemoradiation therapy and continued during the entire course of therapy. Results Twenty six patients met eligibility criteria and completed the entire protocol. The primary tumor sites included tonsil (12), base of tongue (9), posterior pharyngeal wall (1), larynx (4) and hypopharynx (3). Of the 26 patients, 17 were HPV-positive and 9 were HPV-negative. The MTD of Vorinostat was 300 mg administered every other day. Anemia (n = 23/26) and leukopenia (n = 20/26) were the most commonly identified toxicities. The most common Grade3/4 events included leukopenia (n = 11) and lymphopenia (n = 17). No patient had Grade IV mucositis, dermatitis or xerostomia. The median follow time was 33.8 months (range 1.6-82.9 months). Twenty four of 26 (96.2%) patients had a complete response to therapy. Conclusion Vorinostat in combination with concurrent chemoradiation therapy is a safe and highly effective treatment regimen in HNSCC. There was a high rate of complete response to therapy with toxicity rates comparable, if not favorable to existing therapies. Further investigation in Phase II and III trials is strongly recommended.
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Affiliation(s)
- Theodoros N Teknos
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA. .,Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - J Grecula
- Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - A Agrawal
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - M O Old
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - E Ozer
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - R Carrau
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - S Kang
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - J Rocco
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - D Blakaj
- Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - V Diavolitsis
- Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - B Kumar
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - P Kumar
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - Q Pan
- Otolaryngology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - M Palettas
- Center for Biostatistics, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - L Wei
- Center for Biostatistics, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - R Baiocchi
- Hematology-Medical Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
| | - P Savvides
- Hematology-Medical Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), Columbus, OH, USA
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31
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Khoury T, Jang D, Carrau R, Ready N, Barak I, Hachem RA. Role of induction chemotherapy in sinonasal malignancies: a systematic review. Int Forum Allergy Rhinol 2018; 9:212-219. [DOI: 10.1002/alr.22229] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Tawfiq Khoury
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery; Duke University; Durham NC
| | - David Jang
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery; Duke University; Durham NC
| | - Ricardo Carrau
- Department of Otolaryngology-Head & Neck Surgery; Ohio State University Medical Center; Columbus OH
| | - Neal Ready
- Division of Medical Oncology, Department of Medicine; Duke University; Durham NC
| | - Ian Barak
- Biostatistics Core, Department of Biostatistics and Bioinformatics; Duke University School of Medicine; Durham NC
| | - Ralph Abi Hachem
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery; Duke University; Durham NC
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32
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Wolfe A, Klamer B, Pan J, Prevedello D, Bhatt A, Palmer J, Prevedello L, Wakely P, Bonomi M, Carrau R, Blakaj D. The Impact of Adjuvant Radiation Therapy and Elective Nodal Irradiation in Early Stage/Low Grade versus Advanced Stage/High Grade Olfactory Neuroblastoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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33
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Alobid I, Langdon C, López‐Chacon M, Enseñat J, Carrau R, Bernal‐Sprekelsen M, Santamaría A. Total septal perforation repair with a pericranial flap: Radio‐anatomical and clinical findings. Laryngoscope 2018; 128:1320-1327. [DOI: 10.1002/lary.26966] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/12/2017] [Accepted: 09/25/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Isam Alobid
- Rhinology and Skull Base Unit, Department of OtorhinolaryngologyHospital Clinic, University of BarcelonaBarcelona Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)Barcelona Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
| | - Cristóbal Langdon
- Rhinology and Skull Base Unit, Department of OtorhinolaryngologyHospital Clinic, University of BarcelonaBarcelona Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)Barcelona Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
| | - Mauricio López‐Chacon
- Rhinology and Skull Base Unit, Department of OtorhinolaryngologyHospital Clinic, University of BarcelonaBarcelona Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)Barcelona Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
| | - Joaquim Enseñat
- Department of NeurosurgeryHospital Clinic, University of BarcelonaBarcelona Spain
| | - Ricardo Carrau
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
- Department of Otolaryngology–Head and SurgeryThe Ohio State University Wexner Medical CenterColumbus Ohio U.S.A
| | - Manuel Bernal‐Sprekelsen
- Rhinology and Skull Base Unit, Department of OtorhinolaryngologyHospital Clinic, University of BarcelonaBarcelona Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)Barcelona Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
| | - Alfonso Santamaría
- Rhinology and Skull Base Unit, Department of OtorhinolaryngologyHospital Clinic, University of BarcelonaBarcelona Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)Barcelona Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES)Madrid Spain
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34
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Eskander A, Kang S, Tweel B, Sitapara J, Old M, Ozer E, Agrawal A, Carrau R, Rocco JW, Teknos TN. Predictors of Complications in Patients Receiving Head and Neck Free Flap Reconstructive Procedures. Otolaryngol Head Neck Surg 2018; 158:839-847. [DOI: 10.1177/0194599818757949] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Antoine Eskander
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, Ontario, Canada
| | - Stephen Kang
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Ben Tweel
- Department of Otolaryngology–Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jigar Sitapara
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew Old
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Enver Ozer
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Amit Agrawal
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Ricardo Carrau
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - James W. Rocco
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
| | - Theodoros N. Teknos
- Department of Otolaryngology–Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA
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35
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Eskander A, Kang SY, Ozer E, Agrawal A, Carrau R, Rocco JW, Teknos TN, Old MO. Supine positioning for the subscapular system of flaps: A pictorial essay. Head Neck 2018; 40:1068-1072. [DOI: 10.1002/hed.25051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/05/2017] [Accepted: 11/16/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Antoine Eskander
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre; University of Toronto; Toronto Ontario Canada
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Stephen Y. Kang
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Enver Ozer
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Amit Agrawal
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Ricardo Carrau
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - James W. Rocco
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Theodoros N. Teknos
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
| | - Matthew O. Old
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncology; Ohio State University, James Cancer Centre and Solove Research Institute; Columbus Ohio
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Barney CL, Walston S, Zamora P, Healy EH, Nolan N, Diavolitsis VM, Neki A, Rupert R, Savvides P, Agrawal A, Old M, Ozer E, Carrau R, Kang S, Rocco J, Teknos T, Grecula JC, Wobb J, Mitchell D, Blakaj D, Bhatt AD. Clinical outcomes and prognostic factors in cisplatin versus cetuximab chemoradiation for locally advanced p16 positive oropharyngeal carcinoma. Oral Oncol 2018; 79:9-14. [PMID: 29598954 DOI: 10.1016/j.oraloncology.2018.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/29/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Randomized trials evaluating cisplatin versus cetuximab chemoradiation (CRT) for p16+ oropharyngeal cancer (OPC) have yet to report preliminary data. Meanwhile, as a preemptive step toward morbidity reduction, the off-trial use of cetuximab in p16+ patients is increasing, even in those who could potentially tolerate cisplatin. The purpose of this study was to compare the efficacy of cisplatin versus cetuximab CRT in the treatment of p16+ OPC and to identify prognostic factors and predictors of tumor response. MATERIALS AND METHODS Cases of p16+ OPC treated with cisplatin or cetuximab CRT at our institution from 2010 to 2014 were identified. Recursive partitioning analysis (RPA) classification was used to determine low-risk (LR-RPA) and intermediate-risk (IR-RPA) groups. Log-rank/Kaplan-Meier and Cox Regression methods were used to compare groups. RESULTS We identified 205 patients who received cisplatin (n = 137) or cetuximab (n = 68) CRT in the definitive (n = 178) or postoperative (n = 27) setting. Median follow-up was 3 years. Cisplatin improved 3-year locoregional control (LRC) [92.7 vs 65.4%], distant metastasis-free survival (DMFS) [88.3 vs 71.2%], recurrence-free survival (RFS) [86.6 vs 50.6%], and overall survival (OS) [92.6 vs 72.2%] compared to cetuximab [all p < .001]. Concurrent cisplatin improved 3-year OS for LR-RPA (97.1 vs 80.3%, p < .001) and IR-RPA (97.1 vs 80.3%, p < .001) groupings. CONCLUSION When treating p16+ OPC with CRT, the threshold for substitution of cisplatin with cetuximab should be maintained appropriately high in order to prolong survival times and optimize locoregional and distant tumor control. When cetuximab is used in cisplatin-ineligible patients, altered fractionation RT should be considered in an effort to improve LRC.
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Affiliation(s)
- Christian L Barney
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Steve Walston
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Pedro Zamora
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Erin H Healy
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Nicole Nolan
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Virginia M Diavolitsis
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Anterpreet Neki
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Robert Rupert
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Panos Savvides
- The University of Arizona Cancer Center at Dignity Health St. Joseph's Hospital, 625 N 6th St, Phoenix, AZ 85004, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Ricardo Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Stephen Kang
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - James Rocco
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Theodoros Teknos
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - John C Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Jessica Wobb
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Darrion Mitchell
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Dukagjin Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Aashish D Bhatt
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
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Maza G, Yanez-Siller J, Subramaniam S, Otto B, Daniel P, Carrau R. Incidence of Empty Nose Syndrome Following Endoscopic Endonasal Skull Base Surgery: A Preliminary Trial. J Neurol Surg B Skull Base 2018. [DOI: 10.1055/s-0038-1633531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Guillermo Maza
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | - Juan Yanez-Siller
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | | | - Bradley Otto
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | - Prevedello Daniel
- Department of Neurosurgery, Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
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Subramaniam S, Maza G, Gomez M, Carrau R. The Use of Preoperative 3D Volumetric Analysis of Buccal Fat Pad Flap in Determining Intraoperative Flap Reach: A Cadaveric Study. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Guillermo Maza
- The Ohio State University, Columbus, Ohio, United States
| | - Matias Gomez
- The Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University, Columbus, Ohio, United States
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39
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Montaser A, Shahein M, Revuelta Barbero J, Malve G, Todeschini A, Prevedello D, Otto B, Carrau R. Use of Collagen Matrix for Skull Base Reconstruction following Endoscopic Endonasal Resection of Pituitary Adenoma. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Mostafa Shahein
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | | | - Guillermo Malve
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | | | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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40
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Maza G, Subramaniam S, Yanez-Siller J, Otto B, Prevedello D, Carrau R. Transnasal Endoscopic Optic Decompression as the Initial Management of Primary Optic Nerve Sheath Meningiomas. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Guillermo Maza
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | | | - Juan Yanez-Siller
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | - Bradley Otto
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Department of Neurosurgery, Ohio State University, Columbus, Ohio, United States
| | - Ricardo Carrau
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, United States
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41
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Montaser A, Prevedello D, Otto B, Carrau R. Endoscopic Endonasal Surgery for Erdheim–Chester’s Disease of the Clivus: A Case Report. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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42
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VanKoevering K, Cho R, Carrau R, Prevedello D. Outcomes and Technique for Palliative Orbital and Optic Nerve Decompression. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Raymond Cho
- Ohio State University, Columbus, Ohio, United States
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43
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Montaser A, Prevedello D, Otto B, Carrau R. Endoscopic Endonasal Resection of Concomitant Pituitary Adenoma and Rathke’s Cleft Cyst: A Case Report and Review of Literature. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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44
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Montaser A, Prevedello D, Otto B, Carrau R. Endoscopic Endonasal Multimodular Approach for Resection of Concomitant Trigeminal Schwannoma and Pituitary Adenoma: A Single Corridor for Different Pathologies. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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45
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G. M, Naudy C, Sariego H, Walker K, Carrau R, Prevedello D, Otto B, Montaser A, Yanez-Siller J. Endoscopic Approach to Petrous Apex: Clinical Series. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Matias G.
- Instituto de Neurocirugía Dr Asenjo, Chile
| | | | | | | | - Ricardo Carrau
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Daniel Prevedello
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Bradley Otto
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Alaa Montaser
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
| | - Juan Yanez-Siller
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
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46
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Dassi C, Melgarejo A, Montaser A, Prevedello D, Otto B, Carrau R. The Role of Endoscopic Endonasal Surgery in the Management of Skull Base Chondrosarcomas: Technical Nuances and Short-Term Outcome. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Camila Dassi
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ana Melgarejo
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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47
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Conger A, Zhao F, Wang X, Eisenberg A, Griffiths C, Esposito F, Carrau R, Barkhoudarian G, Kelly D. Evolution of the Graded Repair of Cerebrospinal Fluid Leaks and Skull Base Defects in Endonasal Endoscopic Tumor Surgery: Trends in Repair Failure and Meningitis Rates in 509 Patients. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Andrew Conger
- Geisinger Health System, Danville, Pennsylvania, United States
| | - Fan Zhao
- Fudan University, Shanghai, China
| | | | - Amalia Eisenberg
- Pacific Neuroscience Institute, Santa Monica, California, United States
| | - Chester Griffiths
- Pacific Neuroscience Institute, Santa Monica, California, United States
| | | | | | | | - Daniel Kelly
- Pacific Neuroscience Institute, Santa Monica, California, United States
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48
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Montaser A, Barbero J, Shahein M, Yanez-Siller J, Prevedello D, Otto B, Carrau R. Extended Endoscopic Endonasal Clipping of Basilar Apex Aneurysms: Anatomical Comparative Study and Surgical Simulation. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Juan Barbero
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Mostafa Shahein
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Juan Yanez-Siller
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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49
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Montaser A, Gomez M, Beer-Furlan A, Prevedello D, Otto B, Carrau R. The Role of the Expanded Endoscopic Endonasal Approach in Staged Surgery for Giant Olfactory Groove Meningioma: Technical Nuances. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alaa Montaser
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Matias Gomez
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - André Beer-Furlan
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley Otto
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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50
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Kang S, Eskander A, Abi-Hachem R, Teknos T, Ozer E, Old M, Prevedello D, Carrau R. Salvage Skull Base Reconstruction in the Endoscopic Era: The Vastus Lateralis Free Tissue Transfer. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Stephen Kang
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Antoine Eskander
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ralph Abi-Hachem
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Theodoros Teknos
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Enver Ozer
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Matthew Old
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Daniel Prevedello
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo Carrau
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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