Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are diseases that share common clinical a... more Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are diseases that share common clinical and pathophysiological characteristics. Not surprisingly, AR and CRS are commonly comorbid, and each may impact the disease course of the other. AR, in particular, has been identified as one important risk factor and disease modifier for CRS [1].
Cerebellopontine angle (CPA) ganglionic hamartomas are rare. We present a case of a 49-year-old w... more Cerebellopontine angle (CPA) ganglionic hamartomas are rare. We present a case of a 49-year-old woman who presented with left-sided hearing loss of more than 4 years’ duration and vertigo since childhood. Magnetic resonance imaging revealed a mass on the intracanalicular segment of cranial nerve VIII on the left side, consistent with acoustic schwannoma. She opted for observation of the tumor. The patient returned 21 months after the initial evaluation with new-onset left facial weakness. At this time, a working diagnosis of facial nerve neuroma was made. The lesion was excised, and pathology confirmed a diagnosis of left-sided CPA ganglionic hamartoma. Otolaryngologists should be familiar with this uncommon tumor and include it in the differential diagnosis of CPA lesions.
This paper represents the first empirical qualitative research study on Islamophobic violence aga... more This paper represents the first empirical qualitative research study on Islamophobic violence against Muslim women in the Canadian context, and presents a novel characterisation of Islamophobic violence against Muslim women as a form of gender-based violence. Twenty-one Muslim women in Toronto and its surrounding areas were interviewed regarding their encounters with Islamophobic violence: they disclosed over 30 incidents, only three of which were reported to police. The spectrum of Islamophobic violence disclosed by participants includes attempted femicide, physical assault, sexual assault and verbal assault. Moreover, two participants disclosed situations of intimate partner violence (IPV) that were entangled with Islamophobic abuse, representing a hitherto uncharacterised intersection of Islamophobia and IPV in the Canadian context. All incidents of physical and sexual violence disclosed by participants were said to have been perpetrated by white men. Many participants believed t...
British Journal of Medicine and Medical Research, 2014
ABSTRACT Aims: We describe a new, entirely endoscopic surgical technique for treatment of middle ... more ABSTRACT Aims: We describe a new, entirely endoscopic surgical technique for treatment of middle ear myoclonus. Case Presentation: In our patient, the stapedius and tensor tympani tendons were sectioned to control chronic middle ear myoclonus. The procedure was performed using endoscopic ear surgery techniques, with the aid of rigid Hopkins rod endoscopes. Control of the pulsatile tinnitus was achieved after endoscopic tenotomy of the stapedius and tensor tympani, without any complications. Discussion and Conclusion: Endoscopic tensor tympani and stapedius tendon section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as a first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize dissection of healthy tissue for exposure. The entire operation, including raising the tympanomeatal flap and tendon section can be safely completed under visualization with a rigid endoscope with good control of the pulsatile tinnitus. - See more at: http://www.sciencedomain.org/abstract.php?iid=473&id=12&aid=4139#.Uz8Y5blOXIU
Annals of Otology, Rhinology & Laryngology, 2008
Objectives Benign laryngeal polyps usually present with hoarseness and dysphonia. There have been... more Objectives Benign laryngeal polyps usually present with hoarseness and dysphonia. There have been a few reported cases, however, of polyps that caused airway obstruction. Herein we present our series of obstructing laryngeal polyps. Methods A retrospective review was performed of all patients with benign laryngeal lesions treated by the senior author (A.M.S.S.) between 1997 and 2006. Patients who presented with airway obstruction were identified. Detailed information was recorded on the demographics, presenting signs and symptoms, and surgical procedures. Preoperative and postoperative laryngoscopies were reviewed. Results Ten patients were identified. There were 7 women and 3 men. The mean age was 49 years (range, 34 to 64 years). All had a history of vocal abuse and smoking, with a mean of 35.2 pack-years (range, 7.5 to 112.5 pack-years). All underwent microlaryngoscopy with excision of the lesions. Jet ventilation or a small endotracheal tube was used to secure the airway. The me...
SINGING TEACHERS COMMONLY are the primary health care resource for voice students. In addition to... more SINGING TEACHERS COMMONLY are the primary health care resource for voice students. In addition to questions about technique, students often turn to teachers for guidance regarding issues of vocal health. While singing teachers should be very cautious about providing specific guidance without the input of a physician, the greater the teacher's knowledge base, the more likely he/she is to be able to counsel students accurately. Vocal health problems run the gamut from common colds to cancer, and many students have particular concerns about potential environmental hazards that may affect vocal health. One such hazard is asbestos exposure, which is associated clearly with serious lung disease. However, the association with laryngeal cancer is less clear. This article is derived from a prior publication (with permission) and is provided to bring singing teachers up-to-date on what we know about this important problem.1Medicine is replete with assumptions and myths based on faulty reasoning. It is important for all of us to be aware of this problem and diligent about assessing evidence to draw the best possible conclusions. One of the most frequent errors results from post hoc ergo propter hoc reasoning. This classic error in logic assumes that because Event B happens after Event A, Event B is caused by Event A. Proof of causation requires considerably more rigorous evidence. The suggestion that asbestos exposure can cause laryngeal cancer appears to be an example of this flaw in logic.It was estimated in 2008 that in the United States, laryngeal carcinoma would affect 12,250 adults, of whom 3,670 would die. The mean age of diagnosis of laryngeal carcinoma is 65 years, and the mean age of death caused by this tumor is 69 years.2 Known risk factors for laryngeal carcinoma include cigarette smoking and ethanol use. These factors have been shown to have a synergistic effect in the development of carcinoma, and singers and professional voice users should be educated early in their careers to not smoke and to moderate alcohol consumption.In the late 1970s, medical evidence determined a connection between asbestos exposure and mesothelioma, a very aggressive lung cancer. The manufacturing of building materials containing asbestos was stopped. In 1989, the United States EPA (Environmental Protection Agency) banned all new uses of asbestos; uses developed before 1989, however, were still allowed. In 2005, Senators Harry Reid and Bill Frist established a National Asbestos Awareness Day to raise public awareness of the dangers of asbestos exposure.3Asbestos is the name of a group of six naturally occurring minerals which contain long thin fibers that can be easily separated. These fibers are resistant to heat, fire, and chemicals, and they do not conduct electricity. Because asbestos is flame resistant and has excellent insulation properties, it was used extensively in building materials such as ceiling tiles, ductwork for heating and cooling systems, vinyl floor coverings, and others. Asbestos has also been used in the automobile industry, in particular in brake pads and linings and clutches. However, asbestos is usually encountered through occupational exposure including construction work, shipyards, mining, oil refineries, processing plants, chemical and power plants. Firefighters and auto mechanics may also have occupational exposure to asbestos.A possible association between asbestos exposure and laryngeal carcinoma has been evaluated throughout the years. However, there are numerous conflicting reports, and a link between asbestos and laryngeal cancer has not been proven.In 1975, Stell and McGill were the first authors to propose a link between asbestos exposure and laryngeal carcinoma.4 One hundred nineteen patients with squamous cell carcinoma of the larynx were identified. Compared to age-matched controls, a greater proportion of patients had significant asbestos exposure (27.7 vs. 2.5%; p
The Annals of otology, rhinology, and laryngology, 2006
The most common treatment for Graves' disease in the United States is radioactive iodine. Sur... more The most common treatment for Graves' disease in the United States is radioactive iodine. Surgery is performed rarely. The surgery for Graves' disease is usually considered technically difficult. Our goal was to assess the differences in outcomes in patients with Graves' disease who underwent thyroidectomy and in patients without Graves' disease who underwent the same procedures. A retrospective chart review was performed of patients who underwent surgery for Graves' disease between 1997 and 2005. A control group of age-matched and thyroid size-matched patients who underwent thyroidectomy for a diagnosis other than Graves' disease was identified. The groups were statistically compared with respect to length of hospital stay, operative time, and estimated blood loss. Comparison with the published literature was also performed. Eleven patients underwent thyroidectomy for a diagnosis of Graves' disease. The operative time, estimated blood loss, and length of...
Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performe... more Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performed to control pulsatile tinnitus due to middle ear myoclonus and for several other indications. We designed a cadaveric study to assess the feasibility of an entirely endoscopic approach to stapedius and tensor tympani tenotomy. We performed this endoscopic ear surgery in 10 cadaveric temporal bones and summarized our experience. Endoscopic stapedius and tensor tympani section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as the first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize tissue dissection. The entire operation, including raising the tympanomeatal flap and tendon section, can be safely completed under visualization with a rigid endoscope.
The poxviruses including canarypox (ALVAC) and vaccinia viruses are promising vaccine vectors in ... more The poxviruses including canarypox (ALVAC) and vaccinia viruses are promising vaccine vectors in humans, but little is known about their biology in human cells. Using recombinant enhanced green fluorescence protein (EGFP)-expressing ALVAC and vaccinia viruses, we have focused here on a side-by-side comparison of ALVAC and vaccinia virus tropism for cells from human peripheral blood and bone marrow. Both ALVAC and vaccinia viruses showed a strong bias towards monocyte infection. ALVAC minimally infected CD19+ B cells and was unable to infect ex vivo NK cells and T lymphocytes, whereas vaccinia virus could infect B lymphocytes and NK cell populations. Vaccinia virus was also able to infect T lymphocytes at low, but detectable levels that could be enhanced upon their activation. The observed preferential infection of ALVAC or vaccinia virus to monocytes was the result of preferential binding to this population, rather than lineage-specific differences in the expression of viral genes. Moreover, the level of CD14 expression on monocytes correlated with their preference to be infected with ALVAC or vaccinia virus. Both ALVAC and vaccinia viruses could infect immature monocyte derived dendritic cells (MDDCs), but only ALVAC infection induced their subsequent maturation. Vaccinia virus, however, showed greater tropism for mature MDDCs compared to ALVAC. Infection in human bone marrow cultures showed that ALVAC infection was restricted to a myelomonocytoid cell-specific CD33(+) cell population, while vaccinia virus showed a strong, but not exclusive, preference for these cells. These findings have implications in terms of choosing optimal pox virus derived vectors as vaccines in terms of reducing clinical reactogenicity and inducing dendritic cell (DC) maturation.
Objective/HypothesisTo determine the role of aerodigestive tract endoscopy in the management of p... more Objective/HypothesisTo determine the role of aerodigestive tract endoscopy in the management of penetrating neck trauma.Study DesignRetrospective case series.MethodsA search of the hospital's trauma database was performed for patients who presented with penetrating neck trauma between July 1989 and June 2008. The mechanism and site of injury, airway status and manipulation, physical findings, diagnostic and therapeutic steps taken, and outcomes were all recorded.ResultsOne hundred sixty‐three patients were identified. There were 144 males and 19 females. The mean age was 28 years (range, 13 to 65 years). There were 105 gunshot wounds, 9 shotgun injuries, and 48 stab wounds. Seventy‐three patients (45%) underwent emergent neck exploration, of which 15 had upper aerodigestive tract injuries; intraoperative endoscopy was performed on 13 and was used to guide the repair. Ninety patients (55%) did not meet the criteria for emergent neck exploration. Endoscopy in this group was perfor...
Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are diseases that share common clinical a... more Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are diseases that share common clinical and pathophysiological characteristics. Not surprisingly, AR and CRS are commonly comorbid, and each may impact the disease course of the other. AR, in particular, has been identified as one important risk factor and disease modifier for CRS [1].
Cerebellopontine angle (CPA) ganglionic hamartomas are rare. We present a case of a 49-year-old w... more Cerebellopontine angle (CPA) ganglionic hamartomas are rare. We present a case of a 49-year-old woman who presented with left-sided hearing loss of more than 4 years’ duration and vertigo since childhood. Magnetic resonance imaging revealed a mass on the intracanalicular segment of cranial nerve VIII on the left side, consistent with acoustic schwannoma. She opted for observation of the tumor. The patient returned 21 months after the initial evaluation with new-onset left facial weakness. At this time, a working diagnosis of facial nerve neuroma was made. The lesion was excised, and pathology confirmed a diagnosis of left-sided CPA ganglionic hamartoma. Otolaryngologists should be familiar with this uncommon tumor and include it in the differential diagnosis of CPA lesions.
This paper represents the first empirical qualitative research study on Islamophobic violence aga... more This paper represents the first empirical qualitative research study on Islamophobic violence against Muslim women in the Canadian context, and presents a novel characterisation of Islamophobic violence against Muslim women as a form of gender-based violence. Twenty-one Muslim women in Toronto and its surrounding areas were interviewed regarding their encounters with Islamophobic violence: they disclosed over 30 incidents, only three of which were reported to police. The spectrum of Islamophobic violence disclosed by participants includes attempted femicide, physical assault, sexual assault and verbal assault. Moreover, two participants disclosed situations of intimate partner violence (IPV) that were entangled with Islamophobic abuse, representing a hitherto uncharacterised intersection of Islamophobia and IPV in the Canadian context. All incidents of physical and sexual violence disclosed by participants were said to have been perpetrated by white men. Many participants believed t...
British Journal of Medicine and Medical Research, 2014
ABSTRACT Aims: We describe a new, entirely endoscopic surgical technique for treatment of middle ... more ABSTRACT Aims: We describe a new, entirely endoscopic surgical technique for treatment of middle ear myoclonus. Case Presentation: In our patient, the stapedius and tensor tympani tendons were sectioned to control chronic middle ear myoclonus. The procedure was performed using endoscopic ear surgery techniques, with the aid of rigid Hopkins rod endoscopes. Control of the pulsatile tinnitus was achieved after endoscopic tenotomy of the stapedius and tensor tympani, without any complications. Discussion and Conclusion: Endoscopic tensor tympani and stapedius tendon section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as a first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize dissection of healthy tissue for exposure. The entire operation, including raising the tympanomeatal flap and tendon section can be safely completed under visualization with a rigid endoscope with good control of the pulsatile tinnitus. - See more at: http://www.sciencedomain.org/abstract.php?iid=473&id=12&aid=4139#.Uz8Y5blOXIU
Annals of Otology, Rhinology & Laryngology, 2008
Objectives Benign laryngeal polyps usually present with hoarseness and dysphonia. There have been... more Objectives Benign laryngeal polyps usually present with hoarseness and dysphonia. There have been a few reported cases, however, of polyps that caused airway obstruction. Herein we present our series of obstructing laryngeal polyps. Methods A retrospective review was performed of all patients with benign laryngeal lesions treated by the senior author (A.M.S.S.) between 1997 and 2006. Patients who presented with airway obstruction were identified. Detailed information was recorded on the demographics, presenting signs and symptoms, and surgical procedures. Preoperative and postoperative laryngoscopies were reviewed. Results Ten patients were identified. There were 7 women and 3 men. The mean age was 49 years (range, 34 to 64 years). All had a history of vocal abuse and smoking, with a mean of 35.2 pack-years (range, 7.5 to 112.5 pack-years). All underwent microlaryngoscopy with excision of the lesions. Jet ventilation or a small endotracheal tube was used to secure the airway. The me...
SINGING TEACHERS COMMONLY are the primary health care resource for voice students. In addition to... more SINGING TEACHERS COMMONLY are the primary health care resource for voice students. In addition to questions about technique, students often turn to teachers for guidance regarding issues of vocal health. While singing teachers should be very cautious about providing specific guidance without the input of a physician, the greater the teacher's knowledge base, the more likely he/she is to be able to counsel students accurately. Vocal health problems run the gamut from common colds to cancer, and many students have particular concerns about potential environmental hazards that may affect vocal health. One such hazard is asbestos exposure, which is associated clearly with serious lung disease. However, the association with laryngeal cancer is less clear. This article is derived from a prior publication (with permission) and is provided to bring singing teachers up-to-date on what we know about this important problem.1Medicine is replete with assumptions and myths based on faulty reasoning. It is important for all of us to be aware of this problem and diligent about assessing evidence to draw the best possible conclusions. One of the most frequent errors results from post hoc ergo propter hoc reasoning. This classic error in logic assumes that because Event B happens after Event A, Event B is caused by Event A. Proof of causation requires considerably more rigorous evidence. The suggestion that asbestos exposure can cause laryngeal cancer appears to be an example of this flaw in logic.It was estimated in 2008 that in the United States, laryngeal carcinoma would affect 12,250 adults, of whom 3,670 would die. The mean age of diagnosis of laryngeal carcinoma is 65 years, and the mean age of death caused by this tumor is 69 years.2 Known risk factors for laryngeal carcinoma include cigarette smoking and ethanol use. These factors have been shown to have a synergistic effect in the development of carcinoma, and singers and professional voice users should be educated early in their careers to not smoke and to moderate alcohol consumption.In the late 1970s, medical evidence determined a connection between asbestos exposure and mesothelioma, a very aggressive lung cancer. The manufacturing of building materials containing asbestos was stopped. In 1989, the United States EPA (Environmental Protection Agency) banned all new uses of asbestos; uses developed before 1989, however, were still allowed. In 2005, Senators Harry Reid and Bill Frist established a National Asbestos Awareness Day to raise public awareness of the dangers of asbestos exposure.3Asbestos is the name of a group of six naturally occurring minerals which contain long thin fibers that can be easily separated. These fibers are resistant to heat, fire, and chemicals, and they do not conduct electricity. Because asbestos is flame resistant and has excellent insulation properties, it was used extensively in building materials such as ceiling tiles, ductwork for heating and cooling systems, vinyl floor coverings, and others. Asbestos has also been used in the automobile industry, in particular in brake pads and linings and clutches. However, asbestos is usually encountered through occupational exposure including construction work, shipyards, mining, oil refineries, processing plants, chemical and power plants. Firefighters and auto mechanics may also have occupational exposure to asbestos.A possible association between asbestos exposure and laryngeal carcinoma has been evaluated throughout the years. However, there are numerous conflicting reports, and a link between asbestos and laryngeal cancer has not been proven.In 1975, Stell and McGill were the first authors to propose a link between asbestos exposure and laryngeal carcinoma.4 One hundred nineteen patients with squamous cell carcinoma of the larynx were identified. Compared to age-matched controls, a greater proportion of patients had significant asbestos exposure (27.7 vs. 2.5%; p
The Annals of otology, rhinology, and laryngology, 2006
The most common treatment for Graves' disease in the United States is radioactive iodine. Sur... more The most common treatment for Graves' disease in the United States is radioactive iodine. Surgery is performed rarely. The surgery for Graves' disease is usually considered technically difficult. Our goal was to assess the differences in outcomes in patients with Graves' disease who underwent thyroidectomy and in patients without Graves' disease who underwent the same procedures. A retrospective chart review was performed of patients who underwent surgery for Graves' disease between 1997 and 2005. A control group of age-matched and thyroid size-matched patients who underwent thyroidectomy for a diagnosis other than Graves' disease was identified. The groups were statistically compared with respect to length of hospital stay, operative time, and estimated blood loss. Comparison with the published literature was also performed. Eleven patients underwent thyroidectomy for a diagnosis of Graves' disease. The operative time, estimated blood loss, and length of...
Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performe... more Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performed to control pulsatile tinnitus due to middle ear myoclonus and for several other indications. We designed a cadaveric study to assess the feasibility of an entirely endoscopic approach to stapedius and tensor tympani tenotomy. We performed this endoscopic ear surgery in 10 cadaveric temporal bones and summarized our experience. Endoscopic stapedius and tensor tympani section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as the first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize tissue dissection. The entire operation, including raising the tympanomeatal flap and tendon section, can be safely completed under visualization with a rigid endoscope.
The poxviruses including canarypox (ALVAC) and vaccinia viruses are promising vaccine vectors in ... more The poxviruses including canarypox (ALVAC) and vaccinia viruses are promising vaccine vectors in humans, but little is known about their biology in human cells. Using recombinant enhanced green fluorescence protein (EGFP)-expressing ALVAC and vaccinia viruses, we have focused here on a side-by-side comparison of ALVAC and vaccinia virus tropism for cells from human peripheral blood and bone marrow. Both ALVAC and vaccinia viruses showed a strong bias towards monocyte infection. ALVAC minimally infected CD19+ B cells and was unable to infect ex vivo NK cells and T lymphocytes, whereas vaccinia virus could infect B lymphocytes and NK cell populations. Vaccinia virus was also able to infect T lymphocytes at low, but detectable levels that could be enhanced upon their activation. The observed preferential infection of ALVAC or vaccinia virus to monocytes was the result of preferential binding to this population, rather than lineage-specific differences in the expression of viral genes. Moreover, the level of CD14 expression on monocytes correlated with their preference to be infected with ALVAC or vaccinia virus. Both ALVAC and vaccinia viruses could infect immature monocyte derived dendritic cells (MDDCs), but only ALVAC infection induced their subsequent maturation. Vaccinia virus, however, showed greater tropism for mature MDDCs compared to ALVAC. Infection in human bone marrow cultures showed that ALVAC infection was restricted to a myelomonocytoid cell-specific CD33(+) cell population, while vaccinia virus showed a strong, but not exclusive, preference for these cells. These findings have implications in terms of choosing optimal pox virus derived vectors as vaccines in terms of reducing clinical reactogenicity and inducing dendritic cell (DC) maturation.
Objective/HypothesisTo determine the role of aerodigestive tract endoscopy in the management of p... more Objective/HypothesisTo determine the role of aerodigestive tract endoscopy in the management of penetrating neck trauma.Study DesignRetrospective case series.MethodsA search of the hospital's trauma database was performed for patients who presented with penetrating neck trauma between July 1989 and June 2008. The mechanism and site of injury, airway status and manipulation, physical findings, diagnostic and therapeutic steps taken, and outcomes were all recorded.ResultsOne hundred sixty‐three patients were identified. There were 144 males and 19 females. The mean age was 28 years (range, 13 to 65 years). There were 105 gunshot wounds, 9 shotgun injuries, and 48 stab wounds. Seventy‐three patients (45%) underwent emergent neck exploration, of which 15 had upper aerodigestive tract injuries; intraoperative endoscopy was performed on 13 and was used to guide the repair. Ninety patients (55%) did not meet the criteria for emergent neck exploration. Endoscopy in this group was perfor...
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Papers by Sidrah Ahmad