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News Article | April 17, 2017
Site: www.eurekalert.org

3-D printed simulations of lifelike body parts allow surgeons in training the opportunity to practice complex surgeries before assisting with the real thing ANN ARBOR, Mich. - Cher Zhao recently had the rare opportunity to practice skills belonging to the most advanced surgeons: reconstructive cartilage grafting. The setting, however, was fitting for the University of Michigan Medical School resident. Scalpel in hand, Zhao sat at a table carving precise measurements out of realistic material designed to mimic the texture of human cartilage. In the real world, these shapes would be cut from a patient's rib for grafts used for airway or ear reconstruction. In these procedures, then, it's vital that the pieces are carved exactly right. The tool providing Zhao and her peers this immersive experience: Three-dimensional models based on real human cases. Surgical training is one more way University of Michigan researchers are using 3-D printing to advance the quality of care. And the lifelike printed replicas are providing a cost-efficient tool to improve practical experience for more trainees such as Zhao, U-M researchers say in an article published in Otolaryngology- Head and Neck Surgery. Historically, a surgeon's skills have been acquired in live patients, anaesthetized animals or human cadavers, but authors say surgical simulation is increasingly recognized as a vital educational tool. "3-D printing is bringing a whole new meaning to hands-on experience for surgeons in training," says David Zopf, M.D., the article's senior author and a pediatric head and neck surgeon at C.S Mott Children's Hospital. "Hands-on experience is critical for acquiring and improving surgical skills, especially of new and complex procedures," adds Zopf, who keeps a laser 3-D printer in his own office. "This is an exciting tool that not only offers trainees exposure to opportunities they otherwise wouldn't have but that also allows them to demonstrate proficiency of skills before being performed on children." Mott teams have used 3-D printing for almost six years, with the ability to now produce models at a low cost and a much faster rate. The models are based on computer designs of CT scans. The ways in which the technology can be applied are many. Groundbreaking 3-D printed splints made at U-M have helped save the lives of babies with severe tracheobronchomalacia, which causes the windpipe to periodically collapse and prevents normal breathing. Mott has also used 3-D printing on fetuses to plan for potentially complicated births. It also has been applied to complex cases involving surgically removing tumors -- including the full replica of a young patient's skull to plan a best course of action. Such breakthroughs are particularly valuable in pediatric surgery when there are few alternative options for hands-on training. "Airway reconstruction for specialized cases is a technically demanding procedure that often involves carving cartilage to support and expand a reconstructed trachea," says Zopf, who has helped develop high fidelity models for ear reconstruction, cleft lip, and mandible surgery. "Currently, a surgeon in training has scarce opportunity to carve cartilage graft for this type of procedure. We want to see if 3-D printing can accelerate and enhance surgical training." Eighteen surgical trainees in a U-M otolaryngology head and neck surgery dissection course, including Zhao, participated in the exercise last year. They practiced carving on a 3-D printed model of a harvested human cartilage graft created through a CT scan of a pediatric patient's rib. The mold was filled with cornstarch and silicone to give it the real feeling and texture of cartilage. Most participants said the exercise was a very relevant training tool and that the replicas also were useful in demonstrating their skills to teachers. Zhao says the experience may bolster medical training, especially for doctors-to-be like herself who plan to specialize in pediatric otolaryngology treating children with airway disorders. "You only get one chance to carve a harvested graft from a patient's rib, so you have to do it perfectly the first time," she says. "It takes years of practice to learn the technical skills to do it. This was a very realistic experience and what's great is you can keep printing dozens of these models at a time so you can practice over and over again."


News Article | April 17, 2017
Site: www.prweb.com

Dr. Rubinstein has just received the "TOP 500 Award" as a Botox and Juvederm provider. This is a great accomplishment that now positions him above his previous lofty position in the Allergen Diamond top one-percent in the United States. Dr. Ran Y. Rubinstein is dual-certified by the American Board of Facial Plastic Surgery and the American Board of Otolaryngology-Head and Neck Surgery and is now ranked among the top 500 Allergan providers in New York and the Unites States. Why is Being Awarded the "TOP 500 AWARD" Important? Dr. Rubinstein a proud recipient of this award because it shows his extensive experience using the exceptional products offered by Allergan. This important award further validates Dr. Rubinstein's extensive training and expertise with Allergan products since 2010. While other practices have numerous doctors, nurses and trained assistants who perform Botox and Juvederm injections, Dr. Rubinstein has achieved this award based on his own merit. He has earned this new award as he gained extensive experience using Botox and Juvederm treatments, such as Voluma and Volbella. These products are number one in their classification as nonsurgical procedures and are popular among patients who do not need surgery to achieve the outstanding results that Dr. Rubinstein offers. Dr. Ran Y. Rubinstein of Laser and Cosmetic Surgery Specialists is located at 200 Stony Brook Court, Town of Newburgh, New York 12550. Dr. Rubinstein specializes in laser & facial plastic surgery and performs non-surgical and surgical procedures to rejuvenate the face, including the latest in Botox and Juvederm injectable fillers. Dr. Rubinstein offers brow lifts, eyelifts, Smart Lipo, natural face and neck lifts, as-well-as laser skin resurfacing, rhinoplasty and other specialized procedures. Dr. Rubinstein's laser and medical spa specializes in nonsurgical treatment options and is a physician laser training center. Dr. Rubinstein is pleased to offer some of the most advanced laser treatments for hair removal, skin rejuvenation or tightening and non-surgical stretch mark and fat reduction. Dr. Rubinstein proudly offers the latest in Botox and Juvederm injectable fillers by Allergan. Expert Facial Plastic Surgeon Dr. Rubinstein welcomes your questions and will offer you the best nonsurgical or surgical options including injectables by Allergan. Visit YourFaceMD.com, or Call 18458631772 to request an appointment with Dr. Rubinstein who has been awarded Allergan's Top 500 Award in 2017.


News Article | May 3, 2017
Site: news.yahoo.com

Actor Val Kilmer recently revealed that he had cancer that left him with a "swollen" tongue, but exactly what type of cancer could have caused this symptom? On Wednesday, April 26, Kilmer took part in a Reddit AMA ("ask me anything"), and a user asked Kilmer about an incident last year in which actor Michael Douglas suggested Kilmer had oral cancer. Kilmer replied that he did have "a healing of cancer, but my tongue is still swollen [although] healing all the time." This is the first time Kilmer has acknowledged that he'd had cancer, although people have speculated about his health. In 2015, the actor was spotted wearing a tracheostomy tube, which is a tube placed through a surgically made hole in the windpipe that can help people breathe when they have conditions that could block the upper airways, according to the National Institutes of Health. In October 2016, Douglas suggested Kilmer had oral cancer, although at the time, Kilmer denied having the illness. It is still uncertain exactly which type of cancer Kilmer had because the actor has not publically revealed the type. Dr. Dennis Kraus, vice chairman of the Otolaryngology – Head & Neck Surgery department at Lenox Hill Hospital in New York City, said that the use of a tracheostomy tube "could potentially be consistent with" having cancer of the mouth, tongue, base of the tongue or larynx. Kraus has not treated Kilmer, and noted he did not have knowledge of Kilmer's diagnosis or care, other than from reports in the media. [10 Celebrities with Chronic Illnesses] As for swelling of the tongue, this symptom could be caused by a tumor itself or by radiation or surgery treatment for the tumor, Kraus said. Cancers of the oral cavity and larynx are typically linked with using tobacco, and cancers of the mouth are often linked with drinking alcohol, Kraus said. Cancer of the oropharynx, which is the section of the throat that includes the base of the tongue and the tonsils, is often linked with human papillomavirus (HPV) infection, Kraus told Live Science. In recent years, rates of cancers of both the oral cavity and the larynx have fallen as a result of declines in smoking, but cases of oropharynx cancer tied to HPV infections have increased, Kraus said. Outcomes for head and neck cancers vary by case, but even patients with advanced tumors that haven't spread to other areas of the body have "significant potential for being cured" of their cancers, Kraus said.


News Article | April 19, 2017
Site: www.eurekalert.org

In the United States, almost three of every 1,000 children are born with a detectable level of hearing loss in one or both ears. An early-stage researcher at Case Western Reserve University School of Medicine is receiving a major grant to help address the problem in an innovative way. Martin Basch, PhD, assistant professor of otolaryngology - head and neck surgery, has been named a recipient of a 2016 Hartwell Individual Biomedical Research Award. The award helps researchers pursue early-stage, cutting-edge biomedical pediatric research. With the award, Basch will pioneer the study of cell therapies to treat congenital strial deafness, with the goal of restoring hearing. The 2016 award, which provides $300,000 in direct costs for three years, is being given to 12 recipients from 10 institutions nationally. The Hartwell Foundation is a Memphis-based philanthropic institution that funds innovative biomedical research to benefit children of the United States. "I want to express my gratitude to The Hartwell Foundation for recognizing the important work of Dr. Basch and providing generous support for his future critical discoveries," said Lynn Singer, PhD, deputy provost and vice president for academic affairs at Case Western Reserve University. "The Foundation's commitment to supporting the next generation of pediatric researchers is paving the way for better health outcomes for children everywhere." "The Hartwell Foundation seeks to inspire innovation and achievement by offering individual researchers an opportunity to realize their professional goals. We provide an opportunity for those we support to make a difference and to realize their hopes and dreams," said Fred Dombrose, PhD, president of The Hartwell Foundation. With the grant, Basch will focus on developing a therapeutic approach for restoring hearing using a model of congenital strial deafness. Normal hearing requires the proper development of the cochlea, the hearing portion of the inner ear. The cochlea includes the auditory organ that contains the sensory hair cells responsible for sound detection and the stria vascularis, the "battery" that provides the energy for auditory hair cells to function. "Although 30 to 40 percent of congenital hearing loss is accounted for by defects in the stria, the regenerative potential of this complex tissue has been largely unexplored," Basch said. "Over the past decade, considerable and important efforts have been made to understand the biology of the sensory hair cells in the mammalian cochlea, with the aim of applying the principles of embryonic development to regenerative therapies. I will be adding a new focus on the stria vascularis to this vital work." Basch's hypothesis is that specialized cells isolated from the stria vascularis which have not fully differentiated and still preserve many characteristics from their progenitor cells retain the ability to differentiate into functional mature intermediate cells. He will research if such stem cells will restore hearing when injected into the lateral wall of the cochlea in a strial deafness mouse model. "If we are successful," Basch said, "it should be possible to generate equivalent human cell lines and conduct clinical trials, with the potential to benefit the large number of children affected with severe hearing loss due to defects in the stria." In addition to the Individual Biomedical Research Award, Case Western Reserve qualified for a Hartwell Fellowship of $100,000 to support a postdoctoral candidate for two years. CWRU will select its recipient later this spring. Case Western Reserve has seven other faculty members who are current or former Hartwell investigators: Basch, a native of Buenos Aires, Argentina, earned his doctorate in 2004 at the California Institute of Technology and joined the Department of Otolaryngology at CWRU School of Medicine in May 2015. For more information about Case Western Reserve University School of Medicine, please visit: http://case. .


Researchers from UT Southwestern Medical Center have developed a first-of-its-kind nanoparticle vaccine immunotherapy that targets several different cancer types. The nanovaccine consists of tumor antigens – tumor proteins that can be recognized by the immune system – inside a synthetic polymer nanoparticle. Nanoparticle vaccines deliver minuscule particulates that stimulate the immune system to mount an immune response. The goal is to help people’s own bodies fight cancer. “What is unique about our design is the simplicity of the single-polymer composition that can precisely deliver tumor antigens to immune cells while stimulating innate immunity. These actions result in safe and robust production of tumor-specific T cells that kill cancer cells,” said Dr. Jinming Gao, a Professor of Pharmacology and Otolaryngology in UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center. A study outlining this research, published online in Nature Nanotechnology, reported that the nanovaccine had anti-tumor efficacy in multiple tumor types in mice. The research was a collaboration between the laboratories of study senior authors Dr. Gao and Dr. Zhijian “James” Chen, Professor of Molecular Biology and Director of the Center for Inflammation Research. The Center was established in 2015 to study how the body senses infection and to develop approaches to exploit this knowledge to create new treatments for infection, immune disorders, and autoimmunity. Typical vaccines require immune cells to pick up tumor antigens in a “depot system” and then travel to the lymphoid organs for T cell activation, Dr. Gao said. Instead, nanoparticle vaccines can travel directly to the body’s lymph nodes to activate tumor-specific immune responses. “For nanoparticle vaccines to work, they must deliver antigens to proper cellular compartments within specialized immune cells called antigen-presenting cells and stimulate innate immunity,” said Dr. Chen, also a Howard Hughes Medical Institute Investigator and holder of the George L. MacGregor Distinguished Chair in Biomedical Science. “Our nanovaccine did all of those things.” In this case, the experimental UTSW nanovaccine works by activating an adaptor protein called STING, which in turn stimulates the body’s immune defense system to ward off cancer. The scientists examined a variety of tumor models in mice: melanoma, colorectal cancer, and HPV-related cancers of the cervix, head, neck, and anogenital regions. In most cases, the nanovaccine slowed tumor growth and extended the animals’ lives. Other vaccine technologies have been used in cancer immunotherapy. However, they are usually complex – consisting of live bacteria or multiplex biological stimulants, Dr. Gao said. This complexity can make production costly and, in some cases, lead to immune-related toxicities in patients. With the emergence of new nanotechnology tools and increased understanding of polymeric drug delivery, Dr. Gao said, the field of nanoparticle vaccines has grown and attracted intense interest from academia and industry in the past decade. “Recent advances in understanding innate and adaptive immunity have also led to more collaborations between immunologists and nanotechnologists,” said Dr. Chen. “These partnerships are critical in propelling the rapid development of new generations of nanovaccines.” The investigative team is now working with physicians at UT Southwestern to explore clinical testing of the STING-activating nanovaccines for a variety of cancer indications. Combining nanovaccines with radiation or other immunotherapy strategies such as “checkpoint inhibition” can further augment their anti-tumor effectiveness. Study lead authors from UT Southwestern were Dr. Min Luo, research scientist; Dr. Hua Wang, Instructor of Molecular Biology; and Dr. Zhaohui Wang, postdoctoral fellow. Other UTSW researchers involved included graduate students Yang Li, Chensu Wang, Haocheng Cai, and Mingjian Du; Dr. Gang Huang, Instructor of Pharmacology and in the Simmons Comprehensive Cancer Center; Dr. Xiang Chen, research specialist; Dr. Zhigang Lu, Instructor of Physiology; Dr. Matthew Porembka, Assistant Professor of Surgery and a Dedman Family Scholar in Clinical Care; Dr. Jayanthi Lea, Associate Professor of Obstetrics and Gynecology and holder of the Patricia Duniven Fletcher Distinguished Professorship in Gynecological Oncology; Dr. Arthur Frankel, Professor of Internal Medicine and in the Simmons Comprehensive Cancer Center; and Dr. Yang-Xin Fu, Professor of Pathology and Immunology, and holder of the Mary Nell and Ralph B. Rogers Professorship in Immunology. Their work was supported by the National Institutes of Health, the Cancer Prevention and Research Institute of Texas, a UTSW Small Animal Imaging Resource grant and a Simmons Comprehensive Cancer Center support grant.


News Article | May 25, 2017
Site: www.sciencedaily.com

A team of researchers from the National University of Singapore (NUS) has developed a novel handheld device, known as CLiKX, for the treatment of a condition called Otitis Media with Effusion (OME), or 'glue ear', which is the leading cause of hearing loss and visits to the doctors among children worldwide. This NUS invention, which is sensor-guided and easy to use, could significantly improve current surgical treatment of the condition. OME is a condition where the middle ear becomes filled with fluid instead of air. If left untreated, patients may suffer a series of life-altering complications such as hearing impairment, middle ear bone erosion or tumour, and brain infection. OME has also been shown to cause delays in the speech, language and academic abilities of young children. Around the world, there are about 709 million cases of acute OME annually, of which about 90 per cent occurs in children. In Singapore, it is estimated that about 84,000 children suffer from 'glue ear' yearly. The condition is usually treated using medication first, failing which, ear surgery may be needed. Specially designed to improve on the surgical treatment of OME, CLiKX is pioneered by a team led by Associate Professor Tan Kok Kiong from the Department of Electrical and Computer Engineering at the NUS Faculty of Engineering, together with Dr Lynne Lim, an Adjunct Associate Professor with the Department of Otolaryngology at the NUS Yong Loo Lin School of Medicine and Senior Ear Nose and Throat (ENT) Consultant at Mount Elizabeth Medical Centre. "The first line therapy for OME is usually the prescription of antibiotics and treatment of blocked ear tubes. But sometimes, the antibiotics may not be effective against OME. For patients with three or more episodes of OME within a year -- especially if there is hearing loss and speech difficulties, some with craniofacial predispositions, or those who are concerned about building resistance to long term use of antibiotics, grommet tube placement surgery is currently the gold standard of care. A grommet is a very small tube that is inserted onto the patient's ear drum during surgery to help drain away fluid in the middle ear. Each procedure usually takes about 30 minutes under general anaesthesia to complete," explained Dr Lim. Grommet tube placement surgery is carried out in an operating theatre with the use of general anaesthetic, which is a major point of concern for parents who worry about its potential negative impact on brain development in young children. Assoc Prof Tan elaborated, "CLiKX can potentially shift the current standard surgical procedures for OME. With this pistol-like applicator, the grommet tube can be easily inserted into a patient's ear within a single click. In less than a second, the procedure is done. This simple procedure has the potential to be administered in a doctor's consultation room under local anaesthesia, or out of the operating theatre under intravenous conscious sedation without general anaesthesia. Preoperative preparation and postoperative recovery time for patients are significantly reduced. At the same time, risks of general anaesthesia are avoided. We expect costs, manpower and resources to be lowered substantially, and this in turn, would be welcomed by patients, healthcare institutions, and insurers." Grommet tube placement surgery involves making a cut on the eardrum, and placing a tiny ventilation tube, called a grommet, through the hole to drain the ear fluid. The surgery involves a large healthcare team, costly surgical equipment, and set-up in the operating theatre, which is an economic burden not only to patients, but also to hospitals and healthcare insurers. The palm-sized CLiKX can deliver the grommet tube into a patient's ear quickly and safely using a sensor-controlled automation process. This minimises the overall contact time with the patient's eardrum and prevents over-deformation and excessive pressure, thereby reducing discomfort and trauma for the patients. To carry out the procedure, surgeons can potentially use a simple eye-loupe that does not require bulky and costly surgical microscopes. The 185-gram CLiKX also works well with a range of commercially available grommets and does not require any custom-made grommet tubes. In addition, the procedure using CLiKX would potentially require only light or moderate sedation or local anaesthetic. Assoc Prof Tan said, "The motivation behind the development of CLiKX is to significantly reduce the recovery time and treatment cost for patients. By streamlining the manpower and resources required for surgical treatment of OME, healthcare resources could be deployed more efficiently for other treatments and procedures in hospitals." Dr Lim added, "In many underdeveloped areas where proper healthcare infrastructure and general anaesthesia are not always available, many patients with OME do not have access to treatment in a timely manner. Some of these patients have to live with the condition, its associated hearing loss and complications. CLiKX can make a significant impact by making grommet placement surgeries more accessible to these patients most in need, and it simplifies the procedure for doctors and patients." Building on the promising results from the earlier phases of the project, the NUS team aims to conduct the first-in-man trial in Singapore in 2018. The team is keen to work with partners to further develop and commercialise the device, and they aim to launch the device in the market by 2020.


News Article | May 25, 2017
Site: www.businesswire.com

DENVER--(BUSINESS WIRE)--Arlen Meyers, M.D., has joined BridgeHealth as its chief medical officer. BridgeHealth is a leader in making value-based healthcare accessible through high-quality, lower-cost, bundled surgical case rate benefit plans. “Dr. Meyers’ strong clinical expertise and working relationships in the medical community will enhance BridgeHealth’s delivery of high-quality, lower-cost surgical benefits to self-funded employers and their employees and dependents,” said Mark Stadler, BridgeHealth’s chief executive officer. “As chief medical officer, Dr. Meyers will guide us in defining quality care, adding surgical procedures to our benefits solution, conducting medical case reviews and charting the clinical course of our growth.” Meyers is president and chief executive officer of the Society of Physician Entrepreneurs and professor emeritus of otolaryngology, dentistry and engineering at the University of Colorado School of Medicine. He has founded several medical device and digital health companies. Meyers has consulted companies, governments and universities worldwide on bio entrepreneurship, bioscience, healthcare, healthcare IT and medical travel. Meyers serves as associate editor of the Journal of Commercial Biotechnology and Technology Transfer and Entrepreneurship, and Editor-in-Chief of Medscape Reference: Otolaryngology – Head and Neck Surgery. “All my activities are synergistic,” said Meyers. “They’re part of a larger effort to transform our country from ‘sick care’ to value-based healthcare, from provider-centered care to patient-centered care. I’m passionate about this, and BridgeHealth plays a positive, important role in this transformation.” BridgeHealth negotiates with centers of excellence – the nation’s top-performing surgical teams, according to an independent third-party ranking – for episode-of-care case rates. BridgeHealth bundles the charges for each of the most common surgeries into a single discounted price for self-funded employers. Employer customers save 20-40 percent on surgery costs. Employees and their dependents travel to the centers of excellence for the procedures. To encourage employees to use the BridgeHealth benefits, employer customers typically waive deductibles and coinsurance and pay for travel and accommodations. BridgeHealth’s care coordinators provide information and decision support to patients, relieving them of administrative hassle. Founded in 2007, BridgeHealth (www.bridgehealth.com) is a bundled surgical benefit management company that offers a suite of products for self-insured group health plans to improve quality and outcomes of surgery, reduce costs and positively affect the rate of unnecessary surgery. Through decision support, a high-quality narrow network, care coordination and other strategies, clients get real savings in cost and high-quality outcomes while providing an outstanding patient experience through a facilitated process. Clients achieve very quantifiable results for themselves and their employee/plan members in a manner that integrates with their full suite of health plan benefits. BridgeHealth is headquartered in Denver, Colo.


The International Association of HealthCare Professionals is pleased to welcome Dale Amanda Tylor, MD, MPH, FACS, FAAP, FRCSC, to their prestigious organization with her upcoming publication in The Leading Physicians of the World. Dr. Dale Amanda Tylor is a highly trained and qualified pediatric otolaryngologist with an extensive expertise in all facets of her work, especially the treatment of conditions relating to the ears, nose, and throat, with a special skill in treating children. Dr. Tylor has been in practice for more than 15 years and is currently serving patients within the Washington Township Medical Foundation in Fremont, California. Dr. Tylor’s career in medicine began in 2002 when she graduated from McGill University in Montreal, Quebec. Upon receiving her Medical Degree, she completed her General Surgery internship and Otolaryngology residency at the University of Florida, before undertaking her Pediatric Otolaryngology fellowship at Rady Children’s Hospital San Diego, affiliated with the University of California, San Diego. With a passion for public health and patient education, Dr. Tylor went on to complete her Master of Public Health Degree in 2013 from the University of Liverpool in the United Kingdom. Dr. Tylor is board certified in Otolaryngology-Head and Neck Surgery in both the United States and Canada. She has earned the coveted titles of Fellow of the American Academy of Otolaryngology, the American College of Surgeons, and the American Academy of Pediatrics. To keep up to date with the latest advances and developments in her field, Dr. Tylor maintains a professional membership with the American Society of Pediatric Otolaryngology and the Society for Ear, Nose, and Throat Advances in Children. For her wealth of experience and knowledge, she is a member of the Media and Public Relations Committee of the American Academy of Otolaryngology, and has been featured as an expert in a number of publications, television segments, and on the internet. Dr. Tylor attributes her success to being involved in various societies and organizations, as well as staying current with the latest technology in her field. In her free time, she enjoys hiking and participating in marathons. Learn more about Dr. Tylor here: https://www.mywtmf.com/ and be sure to read her upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review.  FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit http://www.findatopdoc.com


A team of researchers from the National University of Singapore (NUS) has developed a novel handheld device, known as CLiKX, for the treatment of a condition called Otitis Media with Effusion (OME), or 'glue ear', which is the leading cause of hearing loss and visits to the doctors among children worldwide. This NUS invention, which is sensor-guided and easy to use, could significantly improve current surgical treatment of the condition. OME is a condition where the middle ear becomes filled with fluid instead of air. If left untreated, patients may suffer a series of life-altering complications such as hearing impairment, middle ear bone erosion or tumour, and brain infection. OME has also been shown to cause delays in the speech, language and academic abilities of young children. Around the world, there are about 709 million cases of acute OME annually, of which about 90 per cent occurs in children. In Singapore, it is estimated that about 84,000 children suffer from 'glue ear' yearly. The condition is usually treated using medication first, failing which, ear surgery may be needed. Specially designed to improve on the surgical treatment of OME, CLiKX is pioneered by a team led by Associate Professor Tan Kok Kiong from the Department of Electrical and Computer Engineering at the NUS Faculty of Engineering, together with Dr Lynne Lim, an Adjunct Associate Professor with the Department of Otolaryngology at the NUS Yong Loo Lin School of Medicine and Senior Ear Nose and Throat (ENT) Consultant at Mount Elizabeth Medical Centre. "The first line therapy for OME is usually the prescription of antibiotics and treatment of blocked ear tubes. But sometimes, the antibiotics may not be effective against OME. For patients with three or more episodes of OME within a year - especially if there is hearing loss and speech difficulties, some with craniofacial predispositions, or those who are concerned about building resistance to long term use of antibiotics, grommet tube placement surgery is currently the gold standard of care. A grommet is a very small tube that is inserted onto the patient's ear drum during surgery to help drain away fluid in the middle ear. Each procedure usually takes about 30 minutes under general anaesthesia to complete," explained Dr Lim. Grommet tube placement surgery is carried out in an operating theatre with the use of general anaesthetic, which is a major point of concern for parents who worry about its potential negative impact on brain development in young children. Assoc Prof Tan elaborated, "CLiKX can potentially shift the current standard surgical procedures for OME. With this pistol-like applicator, the grommet tube can be easily inserted into a patient's ear within a single click. In less than a second, the procedure is done. This simple procedure has the potential to be administered in a doctor's consultation room under local anaesthesia, or out of the operating theatre under intravenous conscious sedation without general anaesthesia. Preoperative preparation and postoperative recovery time for patients are significantly reduced. At the same time, risks of general anaesthesia are avoided. We expect costs, manpower and resources to be lowered substantially, and this in turn, would be welcomed by patients, healthcare institutions, and insurers." Grommet tube placement surgery involves making a cut on the eardrum, and placing a tiny ventilation tube, called a grommet, through the hole to drain the ear fluid. The surgery involves a large healthcare team, costly surgical equipment, and set-up in the operating theatre, which is an economic burden not only to patients, but also to hospitals and healthcare insurers. The palm-sized CLiKX can deliver the grommet tube into a patient's ear quickly and safely using a sensor-controlled automation process. This minimises the overall contact time with the patient's eardrum and prevents over-deformation and excessive pressure, thereby reducing discomfort and trauma for the patients. To carry out the procedure, surgeons can potentially use a simple eye-loupe that does not require bulky and costly surgical microscopes. The 185-gram CLiKX also works well with a range of commercially available grommets and does not require any custom-made grommet tubes. In addition, the procedure using CLiKX would potentially require only light or moderate sedation or local anaesthetic. Assoc Prof Tan said, "The motivation behind the development of CLiKX is to significantly reduce the recovery time and treatment cost for patients. By streamlining the manpower and resources required for surgical treatment of OME, healthcare resources could be deployed more efficiently for other treatments and procedures in hospitals." Dr Lim added, "In many underdeveloped areas where proper healthcare infrastructure and general anaesthesia are not always available, many patients with OME do not have access to treatment in a timely manner. Some of these patients have to live with the condition, its associated hearing loss and complications. CLiKX can make a significant impact by making grommet placement surgeries more accessible to these patients most in need, and it simplifies the procedure for doctors and patients." Building on the promising results from the earlier phases of the project, the NUS team aims to conduct the first-in-man trial in Singapore in 2018. The team is keen to work with partners to further develop and commercialise the device, and they aim to launch the device in the market by 2020.


News Article | May 10, 2017
Site: www.prweb.com

Those suffering from diseases of the salivary glands have trusted the expertise of Ocean Otolaryngology Associates, P.A. in Ocean County, NJ, for nearly 15 years. Stephen Kupferberg, MD, FACS, a board certified otolaryngologist at Ocean Otolaryngology Associates, sheds light on common salivary issues and treatment options through this very informative Q&A session. Q: What are the salivary glands? A: The salivary glands consist of both major and minor salivary glands. The major salivary glands are the parotids, submandibular and sublingual glands. The function of all the glands is to produce saliva to moisten the mouth, aid in digestion and help protect the teeth from decay. The parotid glands empty into the mouth via a single tube called the Stensen’s duct, which is located in the cheek near the second molar of the upper teeth. The submandibular gland empties under the tongue in the front of the mouth through Wharton’s duct. The sublingual gland has many ducts in the floor of the mouth. There are multiple minor salivary glands located in the lips, cheeks and other areas of the mouth and throat. Q: What are common issues that may arise with the salivary glands? A: Several different problems can involve the salivary glands including obstruction, infection, tumors and other disorders. Obstruction most commonly occurs in the parotid and submandibular glands. This may result from the formation of stones in the gland or ducts. Strictures or narrowing can also slow salivary flow. When a person eats, the nervous system signals the gland to increase its production of saliva. This may back up and cause the gland to swell. This swelling usually decreases slowly after a meal. Q: What is the most common salivary infection in children and adults? A: The most common infection in children is mumps, which affects the parotid glands. This usually occurs in children who have not been immunized. Infections also happen in adults. This often occurs in the elderly who become dehydrated or have severe obstructions. These types of infections typically require antibiotic therapy. Q: How can tumors affect the salivary glands? A: Tumors that occur in the salivary glands most commonly present themselves as painless swellings on the side of the face or upper neck. Aggressive tumors can involve the facial nerve, causing decreased movement in portions of the face. Most tumors are benign. Pleomorphic adenoma and Warthin’s tumors are the most common benign lesions. Mucoepidermoid carcinoma is the most common malignant tumors. Q: How are tumors and stones diagnosed? A: Diagnosis is often made by physical examination. A mass can be felt in the cheek or neck. Stones can sometimes be noted by palpation in the mouth. CT scans or MRIs are often necessary to delineate the extent or size of tumors or stones. Q: What is the next course of action if tumors and/or stones are found? A: If a tumor is found, a fine needle aspiration biopsy is often performed to determine the pathology in order to guide further therapy. Small stones may be removed by sialoendoscopy. This involves removing the stones through the ducts with a small camera, graspers, baskets or lasers. Larger stones will necessitate more extensive surgery. Tumors will often require surgical intervention. Tumors involving the parotid gland will often require a superficial or total parotidectomy with facial nerve dissection. Submandibular gland lesions are removed by excising the entire gland. If malignancy is noted, then radiation therapy and possible chemotherapy may be needed. Q: What should you do if you suspect an issue with your salivary glands? A: Consult a board certified Otolaryngologist for diagnosis and treatment options. To schedule an appointment with Ocean Otolaryngology Associates, P.A, call 732-281-0100. About Dr. Stephen Kupferberg Dr. Stephen Kupferberg is a board certified Otolaryngologist and has been in practice for 20 years. He is a graduate of Jefferson Medical College, Philadelphia, PA and completed his internship and residency at the Medical College of Georgia, Augusta, GA. Dr. Kupferberg practiced in Maryland for four years before moving to Toms River where he resides with his wife and two sons. He specializes in hearing loss, nasal and sinus surgery, head and neck surgery, as well as adult and pediatric ear, nose and throat disorders. His leisure time is spent outdoors with his family, cycling, camping, hiking and golfing. About Ocean Otolaryngology Ocean Otolaryngology Associates, P.A. is a respected provider of ear, nose and throat care serving Toms River, Whiting, Brick and surrounding areas. Ocean Otolaryngology’s board certified physicians have extensive training and clinical experience and pursue ongoing education to stay abreast of the latest trends. A wide range of services, including treatment of sinus disease, thyroid disease, hoarseness, hearing loss, childhood ENT disorders and nasal breathing difficulty are provided at the practice’s three Ocean County locations. To learn more about Ocean Otolaryngology Associates, P.A., visit http://www.oceanentfacialplastics.com or call 732-281-0100.

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