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Research by Dr. Roth

Published Research by Dr Roth

The lateral crural underlay spring graft

Ferdinand C A Timmer, Jason A Roth, Pontus K E Börjesson, Peter J F M Lohuis

Facial Plastic Surgery 04/2013; 29(2):140-6.

The objective of this study is to evaluate the functional and aesthetic results obtained from the use of the lateral crural underlay spring (LCUS) graft for the treatment of internal and external nasal valve collapse. In this retrospective study, preoperative and postoperative functional and aesthetic results were compared in patients undergoing treatment for internal or external nasal valve collapse. Results were scored by means of a questionnaire and visual analog scale completed by the patients. Eight patients were recruited and included in this study: 6 (75%) had an improvement in their functional scores, 1 (12%) remained unchanged, and 1 (12%) scored worse. The mean difference in functional scores after the intervention was 9.4 points (p < 0.005). There was no significant difference in aesthetic scores. We found evidence that the LCUS graft is effective for relieving nasal obstruction in patients with internal, external, or combined nasal valve collapse. The amount of increased sidewall tension and rigidity as well as the increase in nasal valve angle and cross-sectional area are determined by the length of the graft, which can be varied according to need.

Ossicular reconstruction with a titanium prosthesis

J A Roth, S R Pandit, M Soma, T R Kertesz

The Journal of Laryngology & Otology 08/2009; 123(10):1082-6

Ossicular chain damage from chronic ear disease is a significant problem in the Australian population. The ideal ossicular chain reconstruction prosthesis has yet to be defined. This paper examines, for the first time, the use of a titanium prosthesis for ossicular chain reconstruction in Australian patients. Retrospective chart review. All patients undergoing ossicular chain reconstruction with a titanium prosthesis between 1 February 2002 and 31 March 2007. Results showed a low complication rate, with only one extrusion out of 55 cases (1.8 per cent). Successful rehabilitation of conductive hearing loss (i.e. to < or =20 dB air-bone gap) was obtained in 85 per cent of the partial ossicular chain reconstruction group and 77 per cent of the total ossicular chain reconstruction group. Pure tone thresholds improved by an average 18 dB in the partial reconstruction group and 25 dB in the total reconstruction group. Titanium is an ideal material for ossicular chain reconstruction due to its ease of insertion, low rate of extrusion and good functional results.

Endoscopic stapling of pharyngeal pouch: a 10 year review of single versus multiple staple rows

Jason A Roth, Elizabeth Sigston, Neil Vallance

Otolaryngology Head and Neck Surgery 02/2009; 140(2):245-9.

To compare the outcomes obtained in patients undergoing endoscopic stapling of pharyngeal pouches with single versus multiple rows of staples. A retrospective, 10-year review. Review of medical records in 38 patients who underwent endoscopic pharyngeal pouch repair. Patients who underwent stapling with multiple rows had a higher postoperative leak rate than patients who were stapled with a single row (36% vs 0%, P < 0.05). Patients with multiple rows also had a more prolonged length of stay and a slower return to both clear fluids and solid diet (P < 0.05). There was no difference in recurrence rate or patient satisfaction between the two groups. The technique of endoscopic pharyngeal pouch stapling has the potential to achieve excellent results. The application of more than one row of staples may be necessary to divide the common wall. However, in our series this is associated with a significantly increased risk of esophageal or pouch perforation. Care should be taken during the placement of multiple rows of staples.

Harmonic scalpel tonsillectomy versus monopolar diathermy tonsillectomy: a prospective study

Jason A Roth, Tobias Pincock, Raymond Sacks, Martin Forer, Neil Boustred, William Johnston, Michael Bailey

Ear, nose, & throat journal 06/2008; 87(6):346-9

For tonsillectomy, the ultrasonic harmonic scalpel has been purported to cause less tissue injury and postoperative morbidity while providing adequate levels of hemostasis. We undertook a prospective study to compare outcomes in 162 patients who had undergone harmonic scalpel tonsillectomy and 40 patients who had undergone monopolar diathermy tonsillectomy over a 33-month period. We found that patients in the harmonic scalpel group experienced significantly less intraoperative bleeding (5.0 vs. 16.5 ml; p < 0.0001). There was no clinically significant difference between the groups with respect to (1) the amount of operating time, (2) the incidence of postoperative nausea and vomiting, dysphonia, and primary or secondary bleeding, and (3) the amount of time patients needed to resume normal diet and activities

Lateral frontal sinus access in endoscopic skull-base surgery

Daniel G Timperley, Catherine Banks, Daniel Robinson, Jason Roth, Raymond Sacks, Richard J Harvey

International Forum of Allergy and Rhinology 1(4):290-5

The modified endoscopic Lothrop (MELP) or Draf III procedure can provide extended endoscopic access to the frontal sinus. The ability to access the entire frontal sinus entirely endoscopically is often debated and there is little published data to predict access based on tumor location. MELP was performed in 10 cadaver heads. Access was defined as the ability to contact the bone under vision with the head of a 70-degree diamond burr. Access was assessed in 3 areas: the orbital roof and the anterior and posterior walls of the frontal sinus. Endpoints were defined in millimeters from medial orbit and lateral quartile zones. Complete lateral access was excellent anterior and posterior in 95% of sinuses (mean 15.5 ± 7.8 mm and 15.4 ± 7.7 mm, respectively). Access to the orbital roof was limited (10.3 ± 4.6 mm; p = 0.01 comparing anterior and posterior). For sinuses pneumatized beyond the midorbital point, only 10% of lateral orbital roofs were contacted. Orbital roof access correlated with the anteroposterior (AP) distance between the olfactory fossa and outer periosteum of the frontal beak (r = 0.6, p < 0.01). Lateral endoscopic access to the walls of the frontal sinus is excellent except for the sinus floor. Access to the orbital roof is reliable in the medial quarter only and minimal lateral to the midorbital point. The ability to predict the areas accessible by the endoscopic approach and those areas that might require ancillary approaches is important for both surgical planning and patient expectations.

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