ORCID Profile
0000-0002-2686-8516
Current Organisations
University of Notre Dame Australia
,
University of Western Australia
,
Sir Charles Gairdner Hospital
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Publisher: SAGE Publications
Date: 19-08-2023
DOI: 10.1177/01455613231194431
Abstract: Spontaneous intracranial hypotension is an uncommon but increasingly recognized condition characterized by an orthostatic headache secondary to low cerebrospinal fluid pressure. Vestibulocochlear symptoms are common but rarely the only presenting feature and can be challenging to differentiate from Meniere’s disease. We present a case series that highlights the common vestibulocochlear symptoms and a review of the literature to increase awareness amongst otolaryngologists and highlight the path to diagnosis and management of this condition
Publisher: MDPI AG
Date: 20-08-2023
DOI: 10.3390/JPM13081276
Abstract: Otoplan is a surgical planning software designed to assist with cochlear implant surgery. One of its outputs is a recommendation of electrode array type based on imaging parameters. In this retrospective study, we evaluated the differences in auditory outcomes between patients who were implanted with arrays corresponding to those recommended by the Otoplan software versus those in which the array selection differed from the Otoplan recommendation. Pre-operative CT images from 114 patients were imported into the software, and array recommendations were generated. These were compared to the arrays which had actually been implanted during surgery, both in terms of array type and length. As recommended, 47% of patients received the same array, 34% received a shorter array, and 18% received a longer array. For reasons relating to structure and hearing preservation, 83% received the more flexible arrays. Those who received stiffer arrays had cochlear malformations or ossification. A negative, although non-statistically significant correlation was observed between the CNC scores at 12 months and the absolute value of the difference between recommended array and implanted array. In conclusion, clinicians may be slightly biased toward shorter electrode arrays due to their perceived greater ability to achieve full insertion. Using 3D imaging during the pre-operative planning may improve clinicians’ confidence to implant longer electrode arrays, where appropriate, to achieve optimum hearing outcomes.
Publisher: Wiley
Date: 06-04-2022
DOI: 10.1111/IMJ.15630
Abstract: There is no registry data on morbidity and mortality of high‐risk cutaneous squamous cell carcinoma (cSCC) in Australia. To examine the clinicopathological features, mortality and morbidity in high‐risk cSCC patients in Western Australia (WA). A retrospective cohort study was conducted through hospital record review on cSCC patients discussed at multidisciplinary meetings at the two largest WA hospitals between March 2015 and December 2016. Of 141 patients, 129 were evaluable, with median follow up of 43.9 (range 3.0–53.2) months. Patients were predominantly older males (84%) with significant comorbidities (Charlson Comorbidity Index (CCI) ≥5 76%) and history of previous nonmelanoma skin cancer (57%) with advanced disease (57% stage IV without distant metastasis American Joint Committee on Cancer, 7th edition). Pathological high‐risk features were common including nodal extracapsular extension (47%) and cranial nerve involvement (16%). Clinical morbidity was significant with a median of 2 (range 0–13) excisions and 2 (range 0–21) cSCC‐related hospitalisations for any cSCC event following the index case discussion. Recurrences of the primary index lesion occurred in 60% of patients and 20% had ≥2 recurrences. Median overall survival for patients with nonmetastatic disease was 39.8 (range 25.9–53.7) months and 16.1 (range 0.2–32.0) months for metastatic disease. CCI ≥5, advanced nodal stage and ≥2 recurrences were significantly associated with mortality on multivariable analyses ( P 0.05). Nodal extracapsular extension and any recurrences were identified as significant risk factors for disease‐specific mortality on multivariable analyses ( P 0.05). High‐risk cSCC patients have significant health needs represented by high‐baseline comorbidities, multiplicity of cSCC events and the number of healthcare‐associated interventions. There is an unmet need for robust cancer data collection.
No related grants have been discovered for PETER FRIEDLAND.