Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Otolaryngology
Total Results:
7730
Evaluating the Stapes as a Landmark for Round Window Identification in Cochlear Implantation
OBJECTIVE:To better understand the distance relationship of the stapes to the round window, to assist in intraoperative round window identification. STUDY DESIGN/METHODS:Retrospective review of CT temporal bone imaging and multiplanar image reformat analysis. SETTING/METHODS:Tertiary referral center. PATIENTS/METHODS:Patients above 18 years of age who underwent cochlear implantation between January 2020 and April 2025 and had preoperative computed tomography (CT) imaging of the temporal bone. Patients were excluded if they had prior surgical procedures that could distort the stapes superstructure (eg, stapedectomy) or if image quality/resolution precluded adequate visualization of the stapes crus. INTERVENTION/METHODS:None. MAIN OUTCOME MEASURE/METHODS:Prediction accuracy of the stapes intercrural width to locate the level of the round window. RESULTS:There were 102 ears that were studied, including 51 (50%) left and 51 (50%) right ears. The average measured intercrural width was 2.1 mm (SD: 0.17 mm). The maximum intercrural distance was found to be 2.6 mm, and the minimum distance was 1.7 mm. In all 102 (100%) ears, the intercrural distance of the stapes accurately predicted the level of the RW on image analysis. CONCLUSION/CONCLUSIONS:The stapes intercrural width can be utilized as an accurate predictor of the round window level and is a simple and intuitive intraoperative tool surgeons can utilize to safely gain access to the cochlea.
PMID: 41094712
ISSN: 1537-4505
CID: 5954902
Sequential and Simultaneous Bilateral Cochlear Implantation in the Elderly Population
OBJECTIVE:Bilateral cochlear implantation (CI) is not routinely recommended in patients of advanced age due to concerns regarding cost-effectiveness and the medical risks of multiple operations in this population. This study seeks to evaluate outcomes of bilateral CI in post-lingually deafened adults over 65 years old. STUDY DESIGN/METHODS:Retrospective cohort study. SETTING/METHODS:Tertiary referral center. PATIENTS/METHODS:Thirty-five post-lingually deafened adults over 65 years at the time of second implantation (CI2) and 11 post-lingually deafened adults over 65 years at the time of simultaneous implantation. INTERVENTIONS/METHODS:Bilateral cochlear implantation. MAIN OUTCOME MEASURES/METHODS:Bilateral CNC word scores at 1 year postoperatively. RESULTS:Bilateral CNC scores were significantly improved compared with preoperative scores 1 year postoperatively in both sequentially implanted patients (d=9.2%, P<0.001) and simultaneously implanted patients (d=44%, P=0.028). No significant correlations were observed between changes in bilateral CNC word scores at 1 year and age at the time of CI1 (r=0.095, P=0.665), age at the time of CI2 (r=0.034, P=0.879), or length of time between implantations (r=0.164, P=0.453) in sequentially implanted patients, nor was age at implantation correlated with changes in bilateral CNC scores at 1 year in simultaneously implanted patients (r=0.548, P=0.452). Finally, bilateral CNC scores of sequentially and simultaneously implanted patients were not found to be different at 1 year (d=4.5%, P=0.8905). CONCLUSIONS:Patients older than 65 years who underwent both sequential and simultaneous bilateral cochlear implantation showed similar and significant improvements in speech perception scores compared with preoperative scores. These outcomes were not correlated with age at the time of implantation or time between implantations in the case of sequentially implanted patients. This suggests that significant benefit can be seen even with advanced age at the time of implantation and longer time between implantations.
PMID: 41185113
ISSN: 1537-4505
CID: 5959572
Overscreening of patients on glucagon-like peptide-1 receptor agonists: A second "epidemic" of thyroid cancer overdiagnosis?
BACKGROUND:Guidelines do not recommend routine screening for thyroid nodules when starting a glucagon-like peptide-1 receptor agonist. Patients, however, increasingly present with incidental nodules from imaging ordered at glucagon-like peptide-1 receptor agonist initiation. METHODS:This retrospective case-control study examined patients in a single academic health system from 1 January 2019 to 31 December, 2024 who underwent thyroid ultrasound, fine-needle aspiration biopsy, molecular testing, and/or surgery with glucagon-like peptide-1 receptor agonist initiation compared with patients not prescribed a glucagon-like peptide-1 receptor agonist. Patient, prescription, and intervention data were collected. Chart review was also performed for a subset of patients. RESULTS:From 2019 to 2024, 2,523 patients prescribed a glucagon-like peptide-1 receptor agonist underwent thyroid ultrasound; from 2020 to 2023, there was a higher growth rate of ultrasound scans ordered for them. A random sample of 415 patients prescribed a glucagon-like peptide-1 receptor agonist showed that most ultrasounds were ordered for "thyroid nodules" by the endocrinologist who prescribed glucagon-like peptide-1 receptor agonist. In this subset, 757 nodules were detected on ultrasound; 10.6% (80/757) had fine-needle aspiration biopsy. Cytology showed 3.8% were Bethesda I (3/80), 72.5% Bethesda II (58/80), 15% Bethesda III (12/80), 0% Bethesda IV (0/80), 2.5% Bethesda V (2/80), and 6.6% Bethesda VI (5/80). Of 15 indeterminate nodules, 11 had molecular testing: 5 were positive or suspicious, including fusions, alterations, RAS and BRAF mutations. Sixteen patients had thyroid surgery after glucagon-like peptide-1 receptor agonist initiation (8 total thyroidectomies, 8 hemithyroidectomies, 1 completion). Final pathology demonstrated 6 benign, 10 malignant, 1 NIFTP. The rate of malignancy in the subset was 2.4% (10/415). CONCLUSION/CONCLUSIONS:The malignancy rate in patients prescribed a glucagon-like peptide-1 receptor agonist remains low, but ultrasound screening rates increased for a period. Strong clinical suspicion should govern screening.
PMID: 41371825
ISSN: 1532-7361
CID: 5977492
Nanoparticle-mediated antagonism of sustained endosomal signaling of the calcitonin receptor-like receptor provides enhanced and persistent relief of oral cancer pain
ISI:001597018400001
ISSN: 0142-9612
CID: 5966152
Implementing the NYU Electronic Patient Visit Assessment (ePVA)© for head and neck cancer in rural and urban populations: a study protocol for a type 1 hybrid effectiveness-implementation clinical trial
BACKGROUND:for HNC as a digital patient-reported symptom monitoring system that enables early symptom detection and real-time interventions at the point of care. With this study protocol, we aim to test the effectiveness of the ePVA in improving HNC outcomes in real-world settings and to identify implementation strategies optimizing its effectiveness. METHODS:We will conduct a longitudinal mixed-methods hybrid type I study at four National Cancer Institute-designated Comprehensive Cancer Centers serving diverse populations in rural and urban settings (New York University, the University of Kansas Cancer Center, Fox Chase Cancer Center, and Baylor College of Medicine) guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Patient eligibility criteria include having histologically diagnosed HNC and undergoing radiation therapy with or without chemotherapy for curative intent. We will also interview clinicians caring for patients with HNC at the participating institutions regarding facilitators and barriers to implementing the ePVA. The accrual goal is 270 patients. Aim 1 is to determine the effect of the ePVA on HNC symptoms in a two-arm (usual care vs. ePVA + usual care) trial. The study's primary outcomes are patients' self-reported social function, senses of taste and smell, and swallowing, measured by the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-H&N35. For Aim 2, we will interview patients (n = 40) as well as clinicians (n = 30) caring for patients with HNC at the participating institutions regarding facilitators and barriers to implementing the ePVA. In Aim 3, we will integrate Aims 1 and 2 data to identify strategies that optimize the use of the ePVA. DISCUSSION/CONCLUSIONS:The overarching goal of this research is to advance cancer care by identifying implementation standards for effective, widespread use of the ePVA that apply to all patient-reported outcomes in cancer care. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov NCT06030011. Registered on 8 September 2023.
PMCID:12690913
PMID: 41366462
ISSN: 1745-6215
CID: 5977322
Transmuscular vocal fold injury reduces frequency complexity of rat ultrasonic vocalizations
Rapid and precise activation of the laryngeal musculature, particularly the thyroarytenoid (TA), is required for the production of rat ultrasonic vocalizations (USVs). Although the role of the TA in USV production has been established through denervation and excised larynx studies, how TA muscle dysfunction affects USV acoustics remains unknown. This study examined how iatrogenic, transmuscular vocal fold injury influences USV production by comparing acoustic parameters between rats receiving bilateral transmuscular vocal fold injury (including the TA muscle) versus sham surgery. Twenty adult male rats were randomly assigned to injury or sham groups and assessed at 30 or 60 days post-surgery. USVs were recorded at each timepoint (pre- and post-surgery) and analyzed for changes in principal frequency, frequency complexity (standard deviation and sinuosity), power (intensity of the USV), tonality, and duration. Injury significantly decreased USV frequency complexity and reduced the likelihood of producing frequency-modulated vocalizations in both post-surgical time groups. These findings demonstrate that while TA muscle integrity is crucial for frequency modulation, it is not necessary for basic USV production, offering new insights into the biomechanical role of the TA muscle in rat vocalization and laying the groundwork for investigating therapeutic interventions targeting laryngeal muscle function.
PMID: 41371504
ISSN: 1872-7549
CID: 5977482
Advancing CNS tumor diagnostics with expanded DNA methylation-based classification
DNA methylation-based classification is now central to contemporary neuro-oncology, as highlighted by the World Health Organization (WHO) classification of central nervous system (CNS) tumors. We present the Heidelberg CNS Tumor Methylation Classifier version 12.8 (v12.8), trained on 7,495 methylation profiles, which expands recognized entities from 91 classes in version 11 (v11) to 184 subclasses. This expansion is a result of newly identified tumor types discovered through our large online repository and global collaborations, underscoring CNS tumor heterogeneity. The random forest-based classifier achieves 95% subclass-level accuracy, with its well-calibrated probabilistic scores providing a reliable measure of confidence for each classification. Its hierarchical output structure enables interpretation across subclass, class, family, and superfamily levels, thereby supporting clinical decisions at multiple granularities. Comparative analyses demonstrate that v12.8 surpasses previous versions and conventional WHO-based approaches. These advances highlight the improved precision and practical utility of the updated classifier in personalized neuro-oncology.
PMID: 41349541
ISSN: 1878-3686
CID: 5975372
Climate Change, Allergic Rhinitis, and Sinusitis
PMID: 41335404
ISSN: 1538-3598
CID: 5974952
CaBLAM: a high-contrast bioluminescent Ca2+ indicator derived from an engineered Oplophorus gracilirostris luciferase
Monitoring intracellular calcium is central to understanding cell signaling across nearly all cell types and organisms. Fluorescent genetically encoded calcium indicators (GECIs) remain the standard tools for in vivo calcium imaging, but require intense excitation light, leading to photobleaching, background autofluorescence and phototoxicity. Bioluminescent GECIs, which generate light enzymatically, eliminate these artifacts but have been constrained by low dynamic range and suboptimal calcium affinities. Here we show that CaBLAM ('calcium bioluminescence activity monitor'), an engineered bioluminescent calcium indicator, achieves an order-of-magnitude improvement in signal contrast and a tunable affinity matched to physiological cytosolic calcium. CaBLAM enables single-cell and subcellular activity imaging at video frame rates in cultured neurons and sustained imaging over hours in awake, behaving animals. These capabilities establish CaBLAM as a robust and general alternative to fluorescent GECIs, extending calcium imaging to regimes where excitation light is undesirable or infeasible.
PMID: 41331138
ISSN: 1548-7105
CID: 5974882
How We Do It: Neuromodulators for Optimization of Blepharoplasty and Brow Lift Procedures
PMID: 40433963
ISSN: 1524-4725
CID: 5855342
