Melissa A. Pynnonen

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OBJECTIVE Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. Despite the frequency of tympanostomy tube insertion, there are(More)
OBJECTIVE This study compared postoperative technical, quality-of-life, and cost outcomes following either robotic or open thyroidectomy for thyroid nodules and cancer. DATA SOURCES PubMed, Ovid MEDLINE, EMBASE, ISI Web of Science, and the Cochrane Central Register of Controlled Trials. REVIEW METHODS We examined relevant controlled trials, comparative(More)
BACKGROUND The objectives of this study were, first, to confirm the presence of multiple domains within the Sino-Nasal Outcome Test 20 (SNOT-20) using a medically treated population, and, second, to reanalyze data from this population to reveal incremental information. A prospective, randomized controlled trial was performed. METHODS One hundred(More)
BACKGROUND Tonsillectomy is a very common operation and is performed using various surgical methods. Coblation is a popular method because it purportedly causes less pain than other surgical methods. However, the superiority of coblation is unproven. OBJECTIVES To compare the effects of coblation tonsillectomy for chronic tonsillitis or tonsillar(More)
OBJECTIVE To evaluate the factors related to surgical complications, rate of gastrostomy tube (G-tube) dependence, and hospitalization in patients undergoing reconstruction with a pectoralis myocutaneous flap vs a soft-tissue revascularized flap. DESIGN Quasi-experimental case series with a historic control group. POPULATION A total of 179 patients (138(More)
OBJECTIVES To identify significant clinical and pathological predictors of survival in mucosal melanoma of the head and neck. DESIGN Retrospective case series. We reviewed cases of mucosal melanoma of the head and neck from a prospectively collected database after institutional review board approval. SETTING A single academic institution. PATIENTS(More)
OBJECTIVE To determine if oral probiotics as adjunctive treatment are more effective than placebo in improving quality of life in patients with chronic inflammatory rhinosinusitis. DESIGN Prospective, randomized, double-blind, placebo-controlled trial. METHODS A total of 77 patients with chronic inflammatory rhinosinusitis were randomly assigned to(More)
Modern medical decision making is a complex task requiring collaboration between patients and physicians. Related clinical evidence may delineate a clearly favorable path, but in other instances, uncertainty remains. Even in these circumstances, however, there are techniques that optimize decision making by blending existing evidence with individual patient(More)
BACKGROUND The microbiota of the nares has been widely studied. However, relatively few studies have investigated the microbiota of the nasal cavity posterior to the nares. This distinct environment has the potential to contain a distinct microbiota and play an important role in health. RESULTS We obtained 35,142 high-quality bacterial 16S rRNA-encoding(More)
OBJECTIVE To determine if isotonic sodium chloride (hereinafter "saline") nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays at improving quality of life and decreasing medication use. DESIGN A prospective, randomized controlled trial. SETTING Community. PARTICIPANTS A total of(More)