Hamed Sajjadi, MD, FACS

All Publications

• Foreign Body Reaction Requiring Re-Exploration After Tympanoplasty With Porcine Small Intestinal Submucosa Reconstruction. The Annals of otology, rhinology, and laryngology Fullerton, Z. H., Wei, E. X., Green, A., Sajjadi, H. 2023: 34894231218900

  Abstract

  OBJECTIVE: We present the first published case of large foreign body reaction to Biodesign (Cook Medical, Bloomington, IN), an acellular otologic graft matrix derived from porcine small intestinal submucosa, after use in tympanoplasty surgery in a patient without previous exposure to meat products.METHODS: A single case report of a 39-year-old female who developed tinnitus, ear drainage, and large fibrotic mass in external auditory canal and extending into middle ear after Type I medial graft tympanoplasty with Biodesign Graft. Left endoscopic microdissection and resection of the tympanic membrane and middle ear fibrotic mass were performed.MAIN FINDINGS: Surgical excision of the fibrous mass required extensive microdissection to ensure preservation of the ossicles and chorda tympani. Postoperatively, hearing improved and otalgia and otorrhea resolved.CONCLUSIONS: We report the first case of post-tympanoplasty reaction with the use of Biodesign acellular porcine graft in a patient with no previous known exposure to meat products. Although this presentation appears to be rare, it reinforces the need for careful patient selection and counseling around the use of porcine or other foreign grafts.

  View details for DOI 10.1177/00034894231218900

  View details for PubMedID 38098236

• The Outcome of Cochlear Implantations in Deaf-Blind Patients: A Multicenter Observational Study. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Daneshi, A., Sajjadi, H., Blevins, N., Jenkins, H. A., Farhadi, M., Ajallouyan, M., Hashemi, S. B., Thai, A., Tran, E., Rajati, M., Asghari, A., Mohseni, M., Mohebbi, S., Bayat, A., Saki, N., Emamdjomeh, H., Romiani, M., Hosseinzadeh, F., Nasori, Y., Mirsaleh, M. 2022; 43 (8): 908-914

  Abstract

  OBJECTIVE: This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear implantation (CI) in deaf-blind patients compared with deaf-only patients.STUDY DESIGN: Retrospective cohort study.SETTING: Multiple cochlear implant centers.PATIENTS: The current study was conducted on 17 prelingual deaf-blind children and 12 postlingual deaf-blind adults who underwent CI surgery. As a control group, 17 prelingual deaf children and 12 postlingual deaf adults were selected.INTERVENTION: Cochlear implantation.MAIN OUTCOME MEASURES: Auditory and linguistic performances in children were assessed using the categories of auditory performance (CAP) and Speech Intelligibility Rating (SIR) scales, respectively. The word recognition score (WRS) was also used to measure speech perception ability in adults. The mean CAP, SIR, and WRS cores were compared between the deaf-only and deaf-blind groups before CI surgery and at "12 months" and "24 months" after device activation. Cohen's d was used for effect size estimation.RESULTS: We found no significant differences in the mean CAP and SIR scores between the deaf-blind and deaf-only children before the CI surgery. For both groups, SIR and CAP scores improved with increasing time after the device activation. The mean CAP scores in the deaf-only children were either equivalent or slightly higher than those of the deaf-blind children at "12 months post-CI" (3.94 ± 0.74 vs 3.24 ± 1.25; mean difference score, 0.706) and "24 months post-CI" (6.01 ± 0.79 vs 5.47 ± 1.06; mean difference score, 0.529) time intervals, but these differences were not statistically significant. The SIR scores in deaf-only implanted children were, on average, 0.870 scores greater than the deaf-blind children at "12 months post-CI" (2.94 ± 0.55 vs 2.07 ± 1.4; p = 0.01, d = 0.97) and, on average, 1.067 scores greater than deaf-blind children at "24 months post-CI" (4.35 ± 0.49 vs 3.29 ± 1.20; p = 0.002; d = 1.15) time intervals. We also found an improvement in WRS scores from the "preimplantation" to the "12-month post-CI" and "24-month post-CI" time intervals in both groups. Pairwise comparisons indicated that the mean WRS in the deaf-only adults was, on average, 10.61% better than deaf-blind implanted adults at "12 months post-CI" (62.33 ± 9.09% vs 51.71 ± 10.73%, p = 0.034, d = 1.06) and, on average, 15.81% better than deaf-blind adults at "24-months post-CI" (72.67 ± 8.66% vs 56.8 ± 9.78%, p = 0.002, d = 1.61) follow-ups.CONCLUSION: Cochlear implantation is a beneficial method for the rehabilitation of deaf-blind patients. Both deaf-blind and deaf-only implanted children revealed similar auditory performances. However, speech perception ability in deaf-blind patients was slightly lower than the deaf-only patients in both children and adults.

  View details for DOI 10.1097/MAO.0000000000003611

  View details for PubMedID 35970154

• Canalplasty for Exostosis Removal Comparing Microscopic Versus Endoscopic Ear Surgery Techniques. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Sayyid, Z. N., Vaisbuch, Y., Sajjadi, A., Sajjadi, H. 2021

  Abstract

  OBJECTIVE: To compare an endoscopic versus microscopic approach to removal of exostoses and osteomas in canalplasty procedures.STUDY DESIGN: Retrospective case review.SETTING: Private and tertiary referral centers.PATIENTS: Adult patients requiring canalplasty procedures performed either microscopically or endoscopically for removal of exostosis or osteoma and/or canal stenosis.INTERVENTION: Microscopic or endoscopic canalplasty.MAIN OUTCOME MEASURE: Major outcome measures included assessment of hearing improvement as well as rates of major and minor complications. Standard audiological data were collected before and after the operative procedure. Major complications queried included stenosis, perforation of the tympanic membrane, hearing loss, facial palsy, and osteomyelitis. Minor complications queried included signs of poor wound healing, graft failure, and bleeding or discharge.RESULTS: Forty three canalplasties were performed on 36 patients. Audiometric tests did not significantly differ between endoscopic and microscopic surgeries. There was a moderate linear relationship between date of surgery and duration of surgery for the endoscopic technique, with more recent surgeries taking less time. No major complications were noted. However, significantly fewer endoscopic cases had evidence of minor postoperative complications relative to microscopic cases.CONCLUSIONS: An endoscopic approach to canalplasty is a safe and minimally invasive technique. Significantly fewer postoperative complications occurred after endoscopic canalplasty procedures as compared with microscopic procedures. Endoscopic repair may be preferred to microscopic repairs due to the improved view of the end of the instruments while maintaining a minimally invasive approach with what is likely a decreased operative time as well.

  View details for DOI 10.1097/MAO.0000000000003240

  View details for PubMedID 34172661

• In Reply: Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic NEUROSURGERY Patel, Z. M., Fernandez-Miranda, J., Hwang, P. H., Nayak, J. V., Dodd, R. L., Sajjadi, H., Jackler, R. K. 2020; 87 (2): E162–E163

  View details for Web of Science ID 000593120500027

• In Reply: Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic. Neurosurgery Patel, Z. M., Fernandez-Miranda, J., Hwang, P. H., Nayak, J. V., Dodd, R. L., Sajjadi, H., Jackler, R. K. 2020

  View details for DOI 10.1093/neuros/nyaa156

  View details for PubMedID 32323725

• Letter: Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic. Neurosurgery Patel, Z. M., Fernandez-Miranda, J., Hwang, P. H., Nayak, J. V., Dodd, R., Sajjadi, H., Jackler, R. K. 2020

  View details for DOI 10.1093/neuros/nyaa125

  View details for PubMedID 32293678

• KTP-laser-assisted endoscopic management of glomus tympanicum tumors: A case series. Ear, nose, & throat journal Noel, J. E., Sajjadi, H. 2018; 97 (12): 399–402

  Abstract

  Endoscopic technology is widely used in rhinology and anterior skull base surgery, but it has been less quickly incorporated into otologic practice. The design of the instrumentation forces surgeons to work one-handed and limits depth perception. Nevertheless, endoscopy also offers wide fields of view and access to spaces that are typically difficult to visualize. Its advantages have broadened the type and extent of operations that can be performed via the ear canal. We describe a method of endoscopic resection of glomus tympanicum tumors in 5 adults who had undergone endoscopic or endoscopy- assisted resection. A successful resection was achieved in all patients-exclusively via the ear canal in 4 of them. A KTP laser was used to address the tumor's vascular supply. Attachment of a neonatal feeding tube to the endoscope for use as a suction catheter obviated the need to repeatedly switch instruments while using the laser. At a minimum of 12 months of follow-up, all patients were free of recurrence. Postoperative audiometry detected no significant adverse hearing outcomes in any patient. We conclude that the minimally invasive endoscopic transcanal approach is a feasible technique for addressing middle ear tumors. We have also developed a method that allows surgeons constant use of the KTP laser to resect a glomus tympanicum tumor.

  View details for PubMedID 30540890

• KTP-laser-assisted endoscopic management of glomus tympanicum tumors: A case series ENT-EAR NOSE & THROAT JOURNAL Noel, J. E., Sajjadi, H. 2018; 97 (12): 399–402

  View details for Web of Science ID 000453803200009

• Endoscopic transcanal modified canal-wall-down mastoidectomy for cholesteatoma. World journal of otorhinolaryngology - head and neck surgery Sajjadi, H. 2017; 3 (3): 153–59

  Abstract

  Attic cholesteatoma with antral extension in tight sclerotic mastoid cavities is a common presentation that creates difficult decision-making intraoperatively. Drilling through a sclerotic and small mastoid cavity, keeping the canal wall intactis often difficult and increases the risk of serious injury. Consequently, a canal-wall-down mastoidectomy is often performed. The endoscopic transcanal modified canal-wall-down mastoidectomy approach allows the benefits of an open cavity for cholesteatoma resection and the benefits of a closed cavity for better long-term care and a more normal ear canal and middle ear reconstruction.

  View details for PubMedID 29516060

• Endoscopic middle ear and mastoid surgery for cholesteatoma. Iranian journal of otorhinolaryngology Sajjadi, H. 2013; 25 (71): 63-70

  Abstract

  To reduce incidence of residual cholesteatoma following ear surgery; and to reduce the need for second look "open" mastoidectomy using endoscopic mastoidotomy. Ten-year retrospective chart review of 249 primary cholesteatoma cases (1994-2004) with a minimum follow-up of two years. The first objective was to evaluate the effectiveness of otoendoscopy in reducing the incidence of "cholesteatoma remnant" at the time of primary surgery. The second investigation was to evaluate the effectiveness of otoendoscopy in reducing the need to open the mastoid cavities during "second look operations".Endoscopes were used on all cases as an adjunct to standard microscopic methods. Once all visible cholesteatoma was removed with standard microscopic techniques, endoscopes were utilized in order to identify any "remnants" of cholesteatoma. Endoscopes were also employed during revision second look cases in order to allow the evaluation of intact canal wall mastoid cavities without an open Mastoidectomy approach.Endoscopy at time of primary operations revealed a 22% incidence of hidden cholesteatoma "remnants" despite apparent total microscopic eradication in closed cavity cases, and 10% in open cavity patients. Endoscopic removal of cholesteatoma remnants reduced the long term cholesteatoma "residual" to 9.7% in closed cavity patients. Furthermore, endoscopic surgery significantly reduced the need to open the mastoids during second look operations.Otoendoscopy is a very effective adjunctive method in ear surgery. It allows significant reduction in cholesteatoma residual rate in both closed cavity and open cavity cases. Furthermore, the great majority of second look mastoids can be evaluated endoscopically and thus avoid an open revision Mastoidectomy.

  View details for PubMedID 24303422

• Avicenna's Treatise on Otology in Medieval Persia Meeting of the Otolaryngology-Historical-Society Hamidi, S., Sajjadi, H., Boroujerdi, A., Golshahi, B., Djalilian, H. R. LIPPINCOTT WILLIAMS & WILKINS. 2008: 1198–1203

  Abstract

  Avicenna (AD 980-1037) was one of the best-known physicians of his time. Born in Persia, he gained notoriety both in the local and international scenes. Avicenna's best-known book, Canon of Medicine, was the standard textbook of medicine for more than five centuries in Europe and the Persian Empire. Because no English translation of the entire Canon of Medicine exists, the authors have recently translated the treatise on otologic diseases from Persian into English. Correlation was made with the Arabic text as well to ensure accuracy. This study provides a review of Avicenna's significant contributions to the concepts in anatomy and the pathophysiology of ear diseases. Herbal and nonherbal medications used in the treatment of otologic disorders are also discussed.

  View details for Web of Science ID 000261397200025

  View details for PubMedID 18849889

• Meniere's disease LANCET Sajjadi, H., Paparella, M. M. 2008; 372 (9636): 406-414

  Abstract

  Meniere's disease is a chronic illness that affects a substantial number of patients every year worldwide. The disease is characterised by intermittent episodes of vertigo lasting from minutes to hours, with fluctuating sensorineural hearing loss, tinnitus, and aural pressure. Although there is currently no cure, more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment, or minimally invasive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. Vestibular neurectomy has a very high rate of vertigo control and is available for patients with good hearing who have failed all other treatments. Labyrinthectomy is undertaken as a last resort and is best reserved for patients with unilateral disease and deafness.

  View details for Web of Science ID 000258196000032

  View details for PubMedID 18675691