The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Ellen M. Friedman - One of the best experts on this subject based on the ideXlab platform.
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:ObjectivesThe purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome.MethodsRetrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed.ResultsThe mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and ...
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology–Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:Objectives The purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome. Methods Retrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed. Results The mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and 6.0 years. Outcome measures included a documented conductive hearing loss on audiological assessment and/or persistent middle ear effusion on physical exam. Speech and language skills were also assessed. Conclusions Children with Down syndrome have an increased incidence and persistence of middle ear disease. Additionally, affected children may require multiple surgical interventions for persistent disease and Failed Tube function. The multiple medical problems often associated with Down syndrome result in an increased anesthetic risk for these patients. Therefore, we propose the utility of a durable tympanostomy Tube for more efficient treatment and the avoidance of multiple interventions.
Brett M. Cordes - One of the best experts on this subject based on the ideXlab platform.
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:ObjectivesThe purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome.MethodsRetrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed.ResultsThe mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and ...
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology–Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:Objectives The purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome. Methods Retrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed. Results The mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and 6.0 years. Outcome measures included a documented conductive hearing loss on audiological assessment and/or persistent middle ear effusion on physical exam. Speech and language skills were also assessed. Conclusions Children with Down syndrome have an increased incidence and persistence of middle ear disease. Additionally, affected children may require multiple surgical interventions for persistent disease and Failed Tube function. The multiple medical problems often associated with Down syndrome result in an increased anesthetic risk for these patients. Therefore, we propose the utility of a durable tympanostomy Tube for more efficient treatment and the avoidance of multiple interventions.
Nurupama Madduri - One of the best experts on this subject based on the ideXlab platform.
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:ObjectivesThe purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome.MethodsRetrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed.ResultsThe mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and ...
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S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Otolaryngology–Head and Neck Surgery, 2008Co-Authors: Brett M. Cordes, Nurupama Madduri, Ellen M. FriedmanAbstract:Objectives The purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy Tube (PET) insertion in children with Down syndrome. Methods Retrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy Tube insertion for middle ear disease are analyzed. Results The mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy Tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third Tube insertions, respectively, for persistent pathology and Failed Tube function. The mean age at first Tube insertion was 3.3 years, while the mean age at second and third Tube insertion was 6.9 and 6.0 years. Outcome measures included a documented conductive hearing loss on audiological assessment and/or persistent middle ear effusion on physical exam. Speech and language skills were also assessed. Conclusions Children with Down syndrome have an increased incidence and persistence of middle ear disease. Additionally, affected children may require multiple surgical interventions for persistent disease and Failed Tube function. The multiple medical problems often associated with Down syndrome result in an increased anesthetic risk for these patients. Therefore, we propose the utility of a durable tympanostomy Tube for more efficient treatment and the avoidance of multiple interventions.
Don S. Minckler - One of the best experts on this subject based on the ideXlab platform.
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Results of Trabectome Surgery Following Failed Glaucoma Tube Shunt Implantation: Cohort Study.
Medicine, 2015Co-Authors: Sameh Mosaed, Garrick Chak, Asghar Haider, Ken Y. Lin, Don S. MincklerAbstract:To evaluate the safety and efficacy of Trabectome after Failed Tube shunt surgery.Twenty patients with prior Failed Tube shunt surgery who underwent Trabectome alone were included. All patients had at least 3 months of follow-up. Outcomes measured included intraocular pressure (IOP), glaucoma medications, and secondary glaucoma surgeries. The success for Kaplan-Meier survival analysis is defined as IOP ≤21 mm Hg, IOP reduced by at least 20% from preoperative IOP, and no secondary glaucoma surgery.Mean preoperative IOP was 23.7 ± 6.4 mm Hg and mean number of glaucoma medications was 3.2 ± 1.5. At 12 months, IOP was reduced to 15.5 ± 3.2 mm Hg (P = 0.05) and number of medications was reduced to 2.4 ± 1.5 (P = 0.44). Survival rate at 12 months was 84% and 3 patients required additional glaucoma surgery with 15 patients reaching 12 months follow-up. Other than failure of IOP control and transient hypotony (IOP < 3 mm Hg) day 1 in 2 cases, there were no adverse events.Trabecular bypass procedures have traditionally been considered an approach appropriate for early-to-moderate glaucoma; however, our study indicates benefit in refractory glaucoma as well. Eyes that are prone to conjunctival scarring and hypertrophic wound healing, such as those who have Failed Tube shunt surgery, may benefit from procedures that avoid conjunctival incision such as Trabectome. This study indicates potential benefits in this patient population.Trabectome was safe and effective in reducing IOP at 1-year follow-up in patients with prior Failed Tube shunt surgery, but not effective in reducing medication reliance in these patients.
Louis B. Cantor - One of the best experts on this subject based on the ideXlab platform.
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Shunt revision versus additional Tube shunt implantation after Failed Tube shunt surgery in refractory glaucoma
American journal of ophthalmology, 2000Co-Authors: Avanee A Shah, Darrell Wudunn, Louis B. CantorAbstract:Abstract PURPOSE: To compare Tube shunt revision with additional Tube shunt after Failed Tube shunt surgery. METHODS: We identified 281 patients who underwent a primary Tube shunt procedure from 1985 to 1998 at Indiana University and reviewed 33 eyes of 33 patients that had Failed and required further surgery. Shunt revision was performed in 12, whereas an additional shunt was placed in 21 eyes. Intraocular pressure, antiglaucoma medications, visual acuity, and complications were noted. Success was defined as at least a 25% reduction in intraocular pressure that was deemed clinically adequate. Qualified success was defined as a 25% intraocular pressure reduction but with additional medications or a significant reduction in medications with stable intraocular pressure for preoperative intraocular pressure less than 21 mm Hg. RESULTS: Preoperative intraocular pressures (mean ± 95% confidence interval) for the revision and additional Tube groups were 28.8 ± 5.8 mm Hg and 29.8 ± 2.7 mm Hg ( P = .73), with an average follow-up period of 25.2 months (range, 3 to 108 months) and 34.8 months (range, 6 to 84 months), respectively. Final mean intraocular pressure was 25.3 ± 6.7 mm Hg for the revision group and 17.7 ± 3.4 mm Hg for the additional Tube group ( P = .037). Forty-two percent in the revision group versus 62% in the additional Tube group achieved at least a qualified success ( P = .30, Fisher exact test). Corneal edema was a common complication, especially in the additional Tube group. Limitations of this study include the small sample sizes and the uneven distribution of neovascular glaucoma between the two groups (six of 12 in the revision group vs two of 21 in the additional Tube group; P = .015, Fisher exact test). CONCLUSIONS: Our series showed that after Failed Tube shunt surgery, an additional Tube shunt offers better intraocular pressure control than revision by excision of an encapsulated bleb.
