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Dive into the research topics where Timothy DeKlotz is active.

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Featured researches published by Timothy DeKlotz.


Laryngoscope | 2012

Meta-analysis of endoscopic versus sublabial pituitary surgery†‡

Timothy DeKlotz; Stanley H. Chia; Wenxin Lu; Kepher H. Makambi; Edward Aulisi; Ziad E. Deeb

To determine whether the endoscopic or sublabial transseptal transsphenoidal approach for pituitary surgery has superior outcomes or decreased complication rates.


Otolaryngology-Head and Neck Surgery | 2011

Meta-analysis of Endoscopic vs Sublabial Pituitary Surgery

Timothy DeKlotz; Edward Aulisi; Kepher H. Makambi; Wenxin Lu; Stanley H. Chia; Ziad E. Deeb

Objective: Determine whether the endoscopic or sublabial transseptal transsphenoidal approach for pituitary surgery has superior outcomes or decreased complication rates. Method: A Medline search was conducted identifying all relevant literature in the English language from 1998 through 2010. Studies explicitly identifying pure sublabial or completely endoscopic approaches were included. Meta-analysis comparing the two techniques was performed for multiple outcome measures utilizing a random effects approach. Results: A total of 21 endoscopic studies (n = 2335) and 17 sublabial studies (n = 2565) met inclusion criteria. Analysis revealed significantly superior rates of gross tumor resection (79% vs 65%, P < .0001), as well as lower rates of cerebral spinal fluid leak (5% vs 7%, P < .01), septal perforation (0% vs 4%), and postoperative epistaxis (1% vs 4%, P < .0001) for the endoscopic approach compared to the sublabial approach. There was no difference between the 2 techniques in the incidence of meningitis, diabetes insipidus, or resolution of hormonal abnormality. Hospital stay (P = .01) and length of operation were shorter for endoscopic surgery compared to sublabial surgery. Conclusion: The sublabial transsphenoidal approach has been the gold standard for pituitary surgery for many years. However, meta-analysis of the recent literature demonstrates superior outcomes and decreased postoperative complications with the endoscopic approach, potentially justifying a shift toward endoscopic pituitary surgery.


Laryngoscope | 2013

Sinonasal Disease in Polyostotic Fibrous Dysplasia and McCune–Albright Syndrome†‡§¶

Timothy DeKlotz; Hung Jeffrey Kim; Marilyn H. Kelly; Michael T. Collins

To characterize the spectrum, symptoms, progression, and effects of endocrine dysfunction on sinonasal disease in polyostotic fibrous dysplasia (PFD) and McCune–Albright Syndrome (MAS).


Archives of Otolaryngology-head & Neck Surgery | 2017

Association of Hearing Loss and Otologic Outcomes With Fibrous Dysplasia

Alison M. Boyce; Carmen C. Brewer; Timothy DeKlotz; Christopher Zalewski; Kelly A. King; Michael T. Collins; H. Jeffrey Kim

Importance Fibrous dysplasia (FD) and McCune-Albright syndrome (MAS) are rare bone and endocrine disorders in which expansile fibro-osseous lesions result in deformity, pain, and functional impairment. The effect of FD on hearing and otologic function has not been established. Objectives To characterize audiologic and otologic manifestations in a large cohort of individuals with FD/MAS and to investigate potential mechanisms of hearing loss. Design, Setting, and Participants In this natural history study, individuals with craniofacial FD seen at a clinical research center underwent clinical, biochemical, computed tomographic, audiologic, and otolaryngologic evaluations. Main Outcomes and Measures Clinical and radiologic features associated with hearing loss and otologic disease were evaluated. Conductive hearing loss was hypothesized to be associated with narrowing of the external auditory canal (EAC), FD involving the epitympanum, and FD crowding the ossicular chain. Sensorineural hearing loss was hypothesized to be associated with FD affecting the internal auditory canal (IAC) and otic capsule. Results Of the 130 study participants with craniofacial FD who were evaluated, 116 (89.2%) had FD that involved the temporal bone (median age, 19.6 years; range, 4.6-80.3 years; 64 female [55.2%]), whereas 14 (10.8%) had craniofacial FD that did not involve the temporal bone. Of the 183 ears with temporal bone FD, hearing loss was identified in 41 ears (22.4%) and was conductive in 27 (65.9%), sensorineural in 12 (29.3%), and mixed in 2 (4.9%). Hearing loss was mild and nonprogressive in most participants. Whereas EACs were narrower in ears with FD (mean difference [MD], 0.33 mm; 95% CI, 0.11-0.55 mm), this finding was associated with conductive hearing loss in only 4 participants. Fibrous dysplasia crowding of the ossicles was associated with conductive hearing loss (odds ratio [OR], 5.0; 95% CI, 2.1-11.6). The IAC length was not different between ears with and without FD (MD, −0.37; 95% CI, −0.95 to 0.211); however, canals were elongated in ears with sensorineural hearing loss (MD, −1.33; 95% CI, −2.60 to −0.07). Otic capsule involvement was noted in only 4 participants, 2 of whom had sensorineural hearing loss. Both MAS-associated growth hormone excess (OR, 3.1; 95% CI, 1.3-7.5) and neonatal hypercortisolism (OR, 11; 95% CI, 2.5-55) were associated with an increased risk of hearing loss . Conclusions and Relevance Hearing loss in craniofacial FD is common and mild to moderate in most individuals. It typically arises from FD crowding of the ossicular chain and elongation of the IAC, whereas EAC stenosis and otic capsule invasion are less common causes. Individuals with craniofacial FD should undergo otolaryngologic evaluation and monitoring, including assessment to identify those with high-risk features.


Cureus | 2016

Endoscopic Endonasal Approach for Transclival Resection of a Petroclival Meningioma: A Technical Note.

Walter C. Jean; Daniel Felbaum; Amjad Anaizi; Timothy DeKlotz

The endoscopic endonasal transclival approach has been widely described for its use to resect clivus chordomas, but there have only been isolated reports of its use for petroclival meningiomas. These tumors are most often resected utilizing open transpetrosal approaches, but these operations, difficult even in the hands of dedicated skull base surgeons, are particularly challenging if the meningiomas are medially-situated and positioned mainly behind the clivus. For this subset of petroclival meningiomas, a transclival approach may be preferable. We report a meningioma resected via an endoscopic endonasal transclival technique. The patient was a 63-year-old man who presented originally for medical attention because of diplopia related to an abducens palsy on the left. A workup at that time revealed a meningioma contained entirely in the left cavernous sinus, and this was treated with stereotactic radiosurgery. His symptoms resolved and his meningioma was stable on MRI for several years after treatment. The patient was then lost to follow-up until 13 years after radiosurgery when he experienced intermittent diplopia again. At this point, workup revealed a large petroclival meningioma compressing the brainstem. He underwent a successful endoscopic endonasal transclival resection of this tumor. A demonstration of the step-by-step surgical technique, discussion of the nuances of the operation, and a comparison with the open transpetrosal approaches are included in our report.


Otolaryngology-Head and Neck Surgery | 2010

Burning Mouth Syndrome A Rare Manifestation of Lyme Disease

Kaelan Young; Timothy DeKlotz; Michael Reilly

1. Scala, A. C. (2003). Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med , 14, 275291. 2. Zakrzewska J., F. H. (2009). Interventions for the treatment of burning mouth syndrome (Review). The Cochrane Collaboration , 1-22. 3. Franz, J. K. (2003). Lyme disease (Lyme borreliosis). Best Practice & Research Clinical Rheumatology , 17 (2), 241–264. 4. Rubel, J. (2006). Lyme disease symptoms and characteristics: a compilation of peer-reviewed literature reports. Lyme info. Retrieved (2010, September 12) from http://www.lymeinfo.net/medical/LDSymptoms.pdf • Malawista, S. B. (2007). Lyme Disease. In L. A. Goldman, Cecil Medicine (23rd ed., p. Ch. 342). Philadelphia, PA: Saunders Elsevier. • Halperin, J. (1998). Nervous system Lyme disease. Journal of Neurological Sciences , 153, 182–191. • Pachner, A. S. (2007). Lyme neuroborreliosis: infection, immunity, and infl ammation. Lancet Neurol , 6, 544-552. Discussion


Skull Base Surgery | 2017

Navigating the Skull Base - Imaging Pearls and Pitfalls

Eduardo Lacayo; Timothy DeKlotz; Amjad Anaizi; Ann Jay


Skull Base Surgery | 2017

Direct Puncture Embolization for Endonasal Resection of Juvenile Nasopharyngeal Angiofibroma Supplied by Internal Carotid Artery

Timothy DeKlotz; Sarah K. Rapoport; Amjad Anaizi; Andrew B. Stemer


Skull Base Surgery | 2016

Recurrence and Sphenoidal Prolapse of a Rathke Cleft Cyst following Endoscopic Transsphenoidal Resection Presenting with Delayed Spontaneous CSF Leak: A Case Report

Amjad Anaizi; Joshua E. Ryan; Timothy DeKlotz; Rocky Felbaum


CSurgeries | 2016

Endoscopic endonasal approach for odontoidectomy

Walter C. Jean; M.Nathan Nair; Timothy DeKlotz

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Michael T. Collins

National Institutes of Health

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Carmen C. Brewer

National Institutes of Health

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Christopher Zalewski

National Institutes of Health

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Kelly A. King

National Institutes of Health

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Walter C. Jean

George Washington University

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Edward Aulisi

MedStar Washington Hospital Center

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Marilyn H. Kelly

National Institutes of Health

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