94 results match your criteria: "Massachusetts Eye and Ear and Harvard Medical School[Affiliation]"

Time-Drive Activity-Based Costing (TDABC) in Otolaryngology: A Scoping Review.

Otolaryngol Head Neck Surg

December 2024

Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA.

Objective: Accurately measuring the cost of a clinical process is critical to identifying ways to increase the value of a healthcare process. The objective of this study was to review time-driven activity-based costing (TDABC) in otolaryngology and to illustrate areas where value may be increased.

Data Sources: PubMed, Web of Science, Embase, CINAHL Complete, and Business Source Complete from database inception to August 2024.

View Article and Find Full Text PDF

Study Objectives: Epiglottic collapse can obstruct the airway in obstructive sleep apnea (OSA) patients in an anteroposterior (E-ap) or lateral direction (E-lat). The present study investigates the concept that lateral or concentric pharyngeal collapse patterns may remodel the epiglottis and predispose it to lateral collapse. To do so, we hypothesized that the presence of-any form of laterally directed pharyngeal collapse, e.

View Article and Find Full Text PDF

Using machine learning to identify pediatric ophthalmologists.

J AAPOS

November 2024

Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.

This cross-sectional study used data from the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) and machine learning algorithms to identify pediatric ophthalmologists based on physician coding patterns. A random forest model achieved an area under the receiver operating characteristic curve of 0.98, sensitivity of 0.

View Article and Find Full Text PDF

Study Objectives: To examine the feasibility, adherence to therapy, and efficacy of hypoglossal nerve stimulation (HGNS) in adults with Down syndrome (DS) with obstructive sleep apnea.

Methods: Adults patients with DS who met criteria for hypoglossal nerve stimulation were prospectively enrolled. Objective adherence was extracted from a cloud-based compliance database.

View Article and Find Full Text PDF

Prcis: Analysis of CMS Physician Payment data found that physician certification year, degree of urbanization, and estimated income by zip code were significant in predicting the proportion of traditional glaucoma procedures performed by each provider in the United States.

Purpose: The prevalence of microinvasive glaucoma surgery (MIGS) compared to traditional procedures has been increasing in glaucoma management. It is important to understand whether the uptake of new glaucoma procedures is associated with aspects of the physician practice.

View Article and Find Full Text PDF

Importance: Mouth breathing is associated with increased airway resistance, pharyngeal collapsibility, and obstructive sleep apnea (OSA) severity. The common belief is that closing the mouth can mitigate the negative effects of mouth breathing during sleep. However, mouth breathing may serve as an essential route to bypassing obstruction along the nasal route (eg, the velopharynx).

View Article and Find Full Text PDF
Article Synopsis
  • A large-scale genome-wide association study (GWAS) was conducted with over 6000 participants to investigate genetic risk factors for isolated dystonia, aiming to improve upon earlier studies that found no significant genetic links.
  • The study included 4303 dystonia patients and 2362 healthy controls, analyzing various factors like age of onset and affected body areas, but ultimately failed to identify any common genetic variants associated with dystonia.
  • The findings suggest that isolated dystonia may not be influenced by common genetic variations, highlighting the need for more extensive studies like whole-genome sequencing to uncover potential genetic contributions.
View Article and Find Full Text PDF
Article Synopsis
  • Topical therapies targeting Rho-associated protein kinase (ROCK) signalling, such as netarsudil and ripasudil, are commonly used to lower intraocular pressure in patients with glaucoma and ocular hypertension.
  • Although effective in reducing eye pressure, ROCK inhibition may lead to unintended side effects in various eye structures, both positive and negative, highlighted by a systematic review of 170 studies.
  • The review identifies established effects like conjunctival hyperaemia and corneal verticillata, while also pointing out less common side effects and suggesting potential new applications for ROCK inhibitors, particularly in treating corneal issues, although more research is needed for other uses.
View Article and Find Full Text PDF

Objective: The efficacy of hypoglossal nerve stimulation (HGNS) therapy is limited by obstruction of the oropharyngeal lateral walls (OLWs). Our objective was to investigate the effect of palatine tonsillectomy on HGNS efficacy in obstructive sleep apnea (OSA) patients with OLW collapse.

Study Design: Case-control study of patients with moderate-to-severe OSA, complete-or-partial OLW collapse, and small tonsils (1 - 2+).

View Article and Find Full Text PDF

FUS::CREM fusion is a distinct primary driver in rare neoplasms of the head and neck and other anatomic sites. Herein, we describe the clinicopathological, imaging, and molecular features of a malignant epithelioid mesenchymal neoplasm harboring FUS::CREM fusion, arising in the tongue of a 46-year-old male. Clinically, the patient presented with a left upper neck mass.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on diagnosing thyroid cancer using tissue examination and molecular data, highlighting the specific genetic mutations associated with different types of thyroid malignancies, particularly papillary thyroid carcinoma.
  • Researchers conducted a retrospective review of over 5,000 thyroid malignancies and identified 17 tumors with significant genetic alterations, with a special emphasis on the role of a specific gene family in cancer development.
  • The findings suggest the existence of primary genetic drivers and secondary mutations in thyroid cancers, which could contribute to tumor progression and treatment resistance, paving the way for potential targeted therapies.
View Article and Find Full Text PDF

Objective: The epiglottis plays an integral role in the swallowing mechanism and is also implicated as an obstruction site in obstructive sleep apnea (OSA). The underlying causes of epiglottic collapse during sleep remain unclear. This study aimed to investigate the cognitive functions using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the neurophysiological and anatomical factors using videofluoroscopic swallowing studies (VFSS).

View Article and Find Full Text PDF

Importance: Greater understanding of the association between strabismus and mental health conditions across sociodemographic backgrounds may inform strategies to improve mental well-being in this population.

Objective: To describe the association of strabismus with mental health conditions in a diverse cohort of US adults.

Design, Setting, And Participants: This cross-sectional study used data from the National Institutes of Health's All of Us Research Program, an ongoing program launched in 2015.

View Article and Find Full Text PDF
Article Synopsis
  • Differences in the site of pharyngeal collapse can affect the effectiveness of treatments for obstructive sleep apnea (OSA), particularly for patients with complete concentric collapse at the palate (CCCp).
  • Researchers analyzed data from 182 OSA patients to identify specific characteristics in overnight polysomnography that could predict the presence of CCCp, focusing on six flow shape features.
  • Their findings revealed significant associations between certain polysomnographic characteristics and CCCp, leading to enhanced identification methods which were validated with a larger dataset of 466 patients.
View Article and Find Full Text PDF

Retinal detachment.

Nat Rev Dis Primers

March 2024

John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

Retinal detachment (RD) occurs when the neurosensory retina, the neurovascular tissue responsible for phototransduction, is separated from the underlying retinal pigment epithelium (RPE). Given the importance of the RPE for optimal retinal function, RD invariably leads to decreased vision. There are three main types of RD: rhegmatogenous, tractional and exudative (also termed serous) RD.

View Article and Find Full Text PDF

Objective: Patients with superior canal dehiscence syndrome (SCDS) can present with a plethora of auditory and/or vestibular symptoms associated with a bony defect of the superior semicircular canal. While surgical repair is a reasonable option for patients with significant localizing symptoms, the degree of clinical improvement will vary among patients and poses challenges in outcome prediction. This study aims to assess the relationship between preoperative and postoperative symptoms and identify predictors of symptom persistence following repair.

View Article and Find Full Text PDF

Unlabelled: Congenital hearing loss is a common chronic condition affecting children in both developed and developing nations. Viruses correlated with congenital hearing loss include human cytomegalovirus (HCMV) and Zika virus (ZIKV), which causes congenital Zika syndrome. The mechanisms by which HCMV and ZIKV infections cause hearing loss are poorly understood.

View Article and Find Full Text PDF
Article Synopsis
  • The study focused on primary progressive aphasia (PPA) in native Chinese speakers, highlighting the unique challenges posed by the classifier system in Chinese compared to Indo-European languages.
  • Results showed that both semantic variant (sv) PPA and logopenic variant (lv) PPA patients struggled significantly with classifier production, with lvPPA patients performing better in recognition tasks.
  • The findings indicate that classifier processing could serve as a linguistic marker for distinguishing between different PPA variants, with performance linked to specific brain regions involved in language and visual processing.
View Article and Find Full Text PDF

Introduction: Vision loss is common in patients treated with radiotherapy for uveal melanoma. With proton beam irradiation (PBI), the prescribed dose is delivered to the tumor with a sharp dose reduction outside the target volume. However, radiation complications are likely to develop when tumors are located near the optic nerve or fovea.

View Article and Find Full Text PDF

Vestibular schwannoma (VS) is an intracranial tumor arising from neoplastic Schwann cells and typically presenting with hearing loss. The traditional belief that hearing deficit is caused by physical expansion of the VS, compressing the auditory nerve, does not explain the common clinical finding that patients with small tumors can have profound hearing loss, suggesting that tumor-secreted factors could influence hearing ability in VS patients. We conducted profiling of patients' plasma for 66 immune-related factors in patients with sporadic VS ( > 170) and identified and validated candidate biomarkers associated with tumor size (S100B) and hearing (MCP-3).

View Article and Find Full Text PDF

We describe a remote access thyroidectomy technique: robotic thyroidectomy via posterior neck approach using the Da Vinci single port (Sp) robotic system. This approach is feasible and safe in the Western population. Laryngoscope, 134:2779-2782, 2024.

View Article and Find Full Text PDF

Human temporal bones (HTBs) are invaluable resources for the study of otologic disorders and for evaluating novel treatment approaches. Given the high costs and technical expertise required to collect and process HTBs, there has been a decline in the number of otopathology laboratories. Our objective is to encourage ongoing study of HTBs by outlining the necessary steps to establish a pipeline for collection and processing of HTBs.

View Article and Find Full Text PDF