Andrew H. Murr

Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent†

Inflammation/polyp recurrence, adhesions, and middle turbinate lateralization are causes of suboptimal outcomes following sinus surgery and lead to increased rates of revision. A bioabsorbable, drug‐eluting stent was evaluated for its ability to preserve sinus patency by providing controlled steroid delivery to the sinus mucosa. The study objective was to assess safety and efficacy of a steroid‐eluting sinus stent when used following functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis (CRS).

Detection of Fungi in the Nasal Mucosa Using Polymerase Chain Reaction

Hypothesis Fungi have been increasingly recognized as important pathogens in sinusitis. However, detection of fungus with conventional culture techniques is insensitive and unreliable. Polymerase chain reaction (PCR) is an exquisitely sensitive assay that can detect the DNA of 10 or less fungal elements. The aim of this study was to compare the sensitivity of conventional culture techniques using PCR analysis.

Current perspective on temporal bone trauma.

The improved survival of patients sustaining massive head injuries has increased the number of temporal bone fractures being managed by otolaryngologists and neurosurgeons. We performed a prospective analysis of 35 patients with head injury with temporal bone trauma. The major emphasis of this study was to investigate the incidence, management, and outcome of facial nerve injury in such patients and to evaluate the importance of electrodiagnostics in the surgical management of the facial nerve. The results of this study indicate an incidence of fracture type, hearing loss, and facial nerve paralysis similar to that already recorded in the literature. This study underscores the importance of evoked electromyography, or electroneuronography, in assessing facial nerve function. Electroneuronography provided the indications for surgical intervention for facial paralysis. All patients having surgery for facial paralysis as determined by electroneuronographic findings had pathology of the facial nerve.

Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses

Background: The incidence of complications resulting from suppurative otitis media has significantly decreased since the introduction of antibiotics. At the start of the 20th century 50% of all cases of otitis media developed a coalescent mastoiditis. By 1959, the incidence had fallen to 0.4%. Recent studies suggest a current incidence of only 0.24%. Additionally, during the time of Friedrich Bezold (1824‐1908), 20% of patients with mastoiditis developed subperiosteal abscess. Interestingly, this has incidence increased; today nearly 50% of patients diagnosed with coalescent mastoiditis have subperiosteal abscess.

Complications and the time to repair of mandible fractures

Objective: Treatment delays in the operative management of mandible fractures are often unavoidable. We were interested in determining whether delays increased the incidence of complications in these patients.

Effect of steroid-releasing sinus implants on postoperative medical and surgical interventions: an efficacy meta-analysis†

Endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) can be compromised by postoperative inflammation, polyposis, and adhesions, often requiring subsequent interventions. A bioabsorbable, steroid‐releasing sinus implant has been studied in 2 prospective, randomized clinical trials for its ability to preserve sinus patency and reduce medical and surgical interventions after ESS in patients with CRS. The objective of this study was to perform a meta‐analysis of the efficacy results from the 2 trials.

Quantitative Analysis of Fungal DNA in Chronic Rhinosinusitis

Objectives/Hypothesis Fungi have been recognized as important pathogens in sinusitis; however, they are equally present in patients with and without sinusitis. The authors postulated that the quantity of fungal DNA in the nose is determinant of disease, is greater in patients with chronic rhinosinusitis, and is directly correlated to their quality of life.

Otolaryngologic manifestations of human immunodeficiency virus infection

The otolaryngologist is uniquely positioned to detect and pursue manifestations of HIV in the head and neck. The presentation of problems subsequent to HIV infection is quite varied, but close investigation will often reveal treatable problems.

Doxycycline sclerosis of benign lymphoepithelial cysts in patients infected with HIV

Benign lymphoepithelial cysts (BLCs) are a widely recognized cause of parotid gland swelling in HIV‐infected patients. Although they are neither invasive nor associated with malignant degeneration, BLCs can become large and disfiguring. Multiple modalities have been used to control these cysts, but no ideal treatment has been identified. The current study examines the efficacy of doxycycline as a BLC sclerosant in eight patients, and nine BLCs (bilateral BLC in one patient). Follow‐up ranged from 12 to 17 months in all cases. Doxycycline sclerosis controlled further cyst growth in 100% of cases with no serious complications. The BLCs became negligible or unnoticeable in two patients, and in six patients (seven BLCs) the cyst became fibrosed and showed no evidence of further growth over the follow‐up period. Although further studies are needed to determine the long‐term efficacy of this treatment modality, doxycycline sclerosis appears to offer a simple, safe, cost‐effective, office‐based therapeutic option for the treatment of BLCs in patients infected with HIV.

Role of Epstein‐Barr virus and cytomegalovirus in the etiology of benign parotid tumors

Pleomorphic adenomas and Warthins tumors are the two most common benign parotid tumors. Previous studies investigating the role of viruses in tumorigenesis of these neoplasms have been conflicting. The aim of this study was to determine whether Epstein‐Barr virus (EBV) or cytomegalovirus (CMV) might play a role in the pathogenesis of pleomorphic adenomas and Warthins tumors.