Browsing by Author "Stucki, Brenton"
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Item Complications Beyond Borders: A Case Study on a Retained Surgical Towel Leading to an Intra-Abdominal Abscess Post-Hysterectomy(2024-03-21) Oldham, Jake; Judd, Dallin; Hawes, Jaden; Stucki, Brenton; Boyack, BryantBackground: The advancement of surgical techniques and procedures has dramatically improved healthcare outcomes globally. Despite these advancements, surgical interventions inherently carry the risk of complications, some of which can be severe and life-altering. Case Presentation: This report details a severe complication following a hysterectomy performed in Mexico on a 46-year-old woman, who developed an intra-abdominal abscess due to a retained surgical towel—a rare but grave surgical error. Initially, her post-surgical symptoms, including abdominal pain, fever, and malaise, were dismissed by her surgeon in Mexico as typical recovery effects. However, as her condition deteriorated, she sought emergency care in Arizona. A CT scan unveiled a significant abscess in her abdomen, marked by a radio dense ribbon indicative of the forgotten surgical towel. Emergency intervention was necessary to extract the towel and address the abscess, further complicated by the discovery of a multi-drug resistant organism. Conclusion: This incident highlights the paramount importance of adhering to surgical safety standards, the potential hazards of seeking medical procedures abroad, and the necessity for diligent postoperative monitoring and open communication between patients and their medical teams.Item Osteogenesis Imperfecta: Implications of Using Micro-CT for Visualizing Developmental Variation in the Middle and Inner Ear of OIM Mice(2023) Judd, Dallin; Stucki, Brenton; Miller, Courtney; Handler, Emma; Menegaz, Rachel A.; Gonzales, LaurenOsteogenesis Imperfecta: Implications of Using Micro-CT for Visualizing Developmental Variation in the Middle and Inner Ear of OIM Mice Dallin R. Judd1, Brenton R. Stucki1, Courtney A. Miller2, Emma Handler3, Rachel A. Menegaz2, Lauren A. Gonzales2 1 Texas College of Osteopathic Medicine, University of North Texas Health Science Center, TX 2 Department of Physiology and Anatomy, University of North Texas Health Science Center, TX 3 Department of Anatomy and Cell Biology, University of Iowa, IA Osteogenesis imperfecta (OI), also known as brittle bone disease, is a genetic bone disorder caused by mutations in the genes COL1A1 and COL1A2, which are responsible for encoding type I collagen. Much is known regarding the effects of the disease on cranial and postcranial elements. However, little is known regarding the pathogenesis and physical manifestations of OI in the ear despite the high rates of hearing loss in patients with OI (~60% of the population is affected). Because ossification or demineralization of structures in the ear may affect the efficacy of certain treatments like cochlear implants, this information deficit limits the treatment options available for OI patients. Thus, the purpose of our research is to visualize and document anatomic variation in the ears of mice bred to have the Type III OI genetic variant in order to better understand the cause of OI-related hearing loss. 3D models of the middle and inner ears were created from micro-CT scans that also employed two new contrast-enhanced methods to visualize the cochlea and middle ear (malleus, incus, and stapes). All CT scanning were done on the UNTHSC campus using the new Small Animal Imaging Facility (SAIF) as part of a previous study. The scan resolution was approximately 20μm. The studied WT and OIM mouse samples include three time points intended to capture a developmental sequence: 0-day-old (WT=20, OIM=29), 7-day-old (WT=23, OIM=23), and 14-day-old mice (WT=22, OIM=18). The visualization software Avizo was then used to digitally segment the bone of the inner ear and middle ear. Gross anatomic differences are currently being documented for each region. Previous work has shown higher levels of ossification and marked bony encroachment of the otic capsule onto the cochlea in the adult OIM mouse model, potentially damaging the soft tissue of the membranous labyrinth. This research uses micro-CT imaging designed to capture a developmental sequence, giving us the potential to elucidate how and when the bony intrusions are impacting surrounding structures. Insight into this anatomical damage may help further clarify OI-related pathology, including the distinction between hearing loss associated with the middle ear (conductive hearing loss) vs. hearing loss associated with the inner ear (sensorineural hearing loss). Furthermore, a preliminary analysis of the developmental sequence should provide insight into when these anatomical changes are first occurring. Upon completion, this research will demonstrate the efficacy of using these new imaging approaches for studying minute structures of the ear and may markedly advance our understanding of the pathogenesis of OI-related hearing loss.Item Prevalence of Bilateral Frontal Sinus Absence in Cadaveric Specimens: A Cross-Sectional Study(2024-03-21) Fowers, Rylan; Driskill, Austin; Stucki, Brenton; Van Alfen, Braden; Heidenreich, Taylor; Lovely, RehanaPurpose: The frontal sinus is one of four pairs of paranasal sinuses, developed early in gestation and continuing pneumatization into teenage years. Due to the differences in pneumatization, large variability exists in the size and dimensions of the frontal sinus, with the majority of radiologic studies showing prevalence of bilateral frontal sinus agenesis to be between 3-5%. While frontal sinus agenesis has not been identified as a frequent cause of patient complaints, it has contributed to worsening symptoms in certain diseases, and this anatomical variation may pose complicated risks to patient treatments, such as surgery. This study aims to demonstrate the prevalence of bilateral frontal sinus agenesis in a population of fixed cadavers from the United States. Methods: The sagittally hemisected skulls of forty-eight cadavers donors of the HSC Willed Body Program were used for this study, and were not separated based on sex, race, or age. All donors were above the age of 35, allowing for complete pneumatization of the frontal sinuses at the time of hemisection. Initial gross observation of the frontal sinus was performed by the researchers at the midline site of hemisection. If the hollow frontal sinus was not identifiable, sagittal cuts with a bone shear were performed in the bilateral supraorbital regions laterally up to two centimeters from the site of midline hemisection in order to determine if the frontal sinus was present. This method was performed on each of the forty-eight cadaveric skulls. During gross observation and further dissection of the supraorbital regions of the skulls, bilateral presence or absence of the frontal sinuses was noted. Results: Three of the forty-eight donors exhibited bilateral agenesis of the frontal sinus leaving forty-five to exhibit unilateral or bilateral presence of frontal sinuses. This correlates to a prevalence of bilateral frontal sinus absence in 6.25% of the population. Conclusion: This study contributes valuable insights to variations and developmental sequences of the frontal sinus. Literature is consistent regarding prevalence of frontal sinus agenesis in various populations, ranging from 2% to 8% depending on the country of origin; the prevalence of bilateral frontal sinus absence in the sample population of this study was 6.25%. Our findings contribute to current data highlighting prevalence rates, which highlights the importance of noting radiologically determined frontal sinus abnormalities in patient histories, ensuring appropriate care during surgeries and future treatments of conditions such as chronic sinusitis and primary ciliary dyskinesia (PCD).Item Resources and Opportunities Available for Allopathic and Osteopathic Medical Students Pursuing Otolaryngology: A Comprehensive Analysis(2024-03-21) Stucki, Brenton; Patel, Arpan; Judd, Dallin; Bruner, WilliamIntroduction: Otolaryngology, commonly known as Ear, Nose, and Throat (ENT), is a surgical subspecialty dedicated to addressing conditions of the head and neck. It is no surprise that matching into surgical subspecialties such as otolaryngology - head and neck surgery becomes more and more competitive each year. Data indicates that each year on average, students are performing at higher levels than years previous. This increase in competitiveness prompts the development of resources including specialty-specific information to be made more readily available to students. This review aims to identify key ENT organizations in the United States that may provide pivotal tools for medical students. Through an analysis of these organizations, this study reveals opportunities available to medical students through organizations such as research opportunities, conference scholarships, mentorship programs, and avenues for leadership roles. Furthermore, emphasizes the significance of research experience, leadership roles, academic performance, and compelling letters of recommendation, which are crucial in the application process. By focusing on these critical aspects, the primary aim is to highlight resources that can equip medical students with the necessary skills and experiences to apply for an ENT residency successfully.Methods:147 organizations were identified by the University of North Texas Health Science Center (UNTHSC) Gibson Library. A search conducted then by three independent researchers via Google Search contributed an additional 30 organizations. The combination of these sources resulted in a preliminary list of 177 organizations. Three duplicates were eliminated, thus decreasing the list to 174 unique organizations. The next stage of screening was predicated on the relevance of these organizations to the field of Otolaryngology. Three independent researchers excluded 129 entities sourced from the UNTHSC Gibson Library. Further reviews were conducted and a finalized cohort of fourteen national otolaryngology - head and neck surgery organizations were selected for comprehensive evaluation. Information regarding the following information was gathered and compiled for review and comparison: Organization Focuses on a Subspecialty of Otolaryngology, Organization Allows Both MD and DO Student Membership, Medical Student Cost to Join Organization, Annual Meeting, Research Presented at Annual Meeting, Medical Students can Present at Annual Meeting, Medical Student Registration Fee for Annual Meeting, Annual Meeting Registration / Travel Scholarships Available for Medical Students, Mentorship Available Within the Organization for Medical Students, Leadership Opportunities Available for Medical Students, Scholarships/Grants Available for Medical Students, Educational Material Available to Medical Students. Results: The comprehensive analysis highlighted resources and opportunities available for allopathic and osteopathic medical students pursuing otolaryngology. These entities offer numerous benefits, including research opportunities, educational materials, annual meetings, and access to subspecialties. These organizations can provide a competitive edge to medical students who take advantage of these benefits. Conclusion: In conclusion, this analysis underscores the vital support that professional organizations offer to medical students pursuing otolaryngology, highlighting the significance of mentorship, research opportunities, and educational materials. It urges medical students to actively engage with these organizations to enhance their career prospects in this field. However, identified gaps in mentorship, travel financial aid, and leadership roles point towards areas needing enhancement.Item Two Presentations of Neuroglial Heterotopias with Cleft Palate(2024-03-21) Stucki, Brenton; Marcincuk, MichelleIntroduction: Neuroglial heterotopias, commonly known as nasal gliomas, are rare masses composed of brain tissue located outside of the cranial vault. These masses are composed of dysplastic glial cells which have lost their intracranial connections and can present as extranasal, intranasal, or mixed masses. They are thought to result from the incomplete closure of the anterior fontanelle between the nasal and frontal bones; this can result in an irregular connection between embryonic ectoderm and neuroectodermal tissue. Although the presentation of a neuroglial heterotopia in a child is uncommon, even more notable is the finding of neuroglial heterotopias visible from a concurrent cleft palate, as this can present additional difficulties in future cleft palate repair and mass excision. Case Presentation: Presented in this report are two cases of a neuroglial heterotopia found simultaneously with cleft palate. Although these lesions are typically considered benign growths, unmanaged neuroglial heterotopias can result in improper craniofacial development resulting in cosmetic complications and airway obstructions. For accurate diagnosis, thorough histological identification of the embryological tissue origins after surgical biopsy should be performed. Although neuroglial heterotopias and other masses of the nasopharynx such as teratomas have similar treatment methods (namely surgical resection), detailed histological evaluation of tissue biopsies allows physicians to properly manage cases such as these post-treatment. Early surgical removal of neuroglial heterotopias are encouraged in order to minimize nasal and craniofacial distortion early in development as well as to slow or prevent further growth of the lesion. Conclusions: Imaging diagnostics, histological evaluation, surgical procedures, and patient management of the two cases are highlighted in the report in an effort to provide more insight into possible differential diagnoses and treatment options to physicians with similar case presentations.Item Variant Blood Supply of the Superficial Face: A Case Report(2024-03-21) Stucki, Brenton; Fowers, Rylan; Judd, Dallin; Van Alfen, Braden; Rosales, Armando; Lovely, RehanaIntroduction: The facial and transverse facial arteries provide the major arterial supply for the superficial face. The facial artery arises from the external carotid artery, in the carotid triangle of the neck, and crosses the angle of the mandible as it ascends the anterolateral face. Following a distinctive course, it continues by running along the oral commissure where it gives off the superior and inferior labial branches. Continuing its trajectory, the artery ascends along the nasolabial sulcus, providing the lateral nasal branch, and concludes its course by terminating as the angular branch near the medial aspect of the eye. The transverse facial artery, which arises from the superficial temporal artery, has a significant role in lateral face vascularization by supplying blood to the parotid gland, masseter, and integument and terminating near the buccal area. Case Presentation: During a unilateral dissection of a previously hemisected head of a 78-year-old donor from the UNTHSC Willed Body program, variations of the facial and transverse facial arteries were observed. The superficial and deep structures of the face were subsequently dissected and cleaned to expose arterial origins and terminations. The variant anatomical structures were then noted and photographed. The facial artery arose from the external carotid between the lingual and occipital arteries. After crossing the angle of the mandible, the variant facial artery terminated below the oral fissure, supplying blood to the lower face only. The transverse facial artery arose from the superficial temporal, running deep to the parotid gland extending across the lateral face. It then continued in the typical path of the facial artery, following the nasolabial sulcus supplying the muscles and tissues above the oral fissure. It was observed that this variant transverse artery supplied blood to the superficial face instead of the facial artery. Conclusion: The face, like the rest of the human body, has a variety of documented anatomical variations. The observed anatomical variations of the facial and transverse facial arteries highlight the complexity and diversity regarding the vascular supply of the face. The documentation of such variations serves as vital information in clinical and surgical practice to yield the best patient outcomes during treatment.