Stephen G Rothstein, M.D.

Bilateral auricular seromas: A case report and review of the literature
Reitzen, Shari D; Rothstein, Stephen; Shah, Anil R
2011 Dec;90(12):E12-E14, Ear, nose & throat journal
Hematomas, pseudocysts, and seromas are all part of the differential diagnosis of auricular swellings. Seromas are benign collections of serous fluid that have a tendency to recur. The fluid accumulates in the space between the dermis and perichondrium of the ear. We describe what we believe is the first case of spontaneous bilateral auricular seromas to be reported in the literature. One of the seromas resolved in 4 weeks without treatment, and the other resolved with incision and drainage. It is important for physicians to be aware of auricular seromas when considering the differential diagnosis of an auricular swelling, and to understand the various treatment options
— id: 147700, year: 2011, vol: 90, page: E12, stat: Journal Article,

Clinical outcomes for the elderly patient receiving a tracheotomy
Baskin, Jonathan Zvi; Panagopoulos, Georgia; Parks, Christine; Rothstein, Stephen; Komisar, Arnold
2004 Feb;26(1):71-75, Head & neck
BACKGROUND: Tracheotomies are routinely performed for severely ill and elderly patients with respiratory failure. This intervention is questioned, given the poor survival rate in this group. Outcomes analysis is performed after tracheotomy. METHODS: This is a retrospective study of 78 elderly patients, who received tracheotomies for respiratory failure. Pretracheotomy data (age, length of oral intubation, and DNR status) were collected. Outcomes analyzed during the same admission as the tracheotomy included death versus discharge, ventilator dependence, vocal function, route of feeding, decannulation, and ICU discharge disposition. RESULTS: The mean age was 77.6 +/- 11 years (median, 79 years) and patients were intubated for 16.7 +/- 9 days. Forty-two percent (n = 33) obtained DNR orders after tracheotomy, and 8% (n = 6) before tracheotomy. Seventy-one percent of patients (n = 55) had gastrostomy tubes placed. Fifty-six percent of patients (n = 44) died after tracheotomy; median time from tracheotomy to death was 31 days. After tracheotomy, 53 % (n = 41) remained at least partially ventilator dependent, 18 % (n = 14) regained consistent vocal function, and 13 % (n = 10) were decannulated. For those who died, 27 % (n = 12) died without leaving the ICU. CONCLUSION: These data demonstrate that a large proportion of elderly, severely ill patients with respiratory failure suffer poor outcomes after tracheotomy. More stringent criteria are necessary for performing the tracheotomy in this patient population
— id: 46197, year: 2004, vol: 26, page: 71, stat: Journal Article,

Tuberculosis of the head and neck
Sikora AG; Rothstein SG; Garay KF; Spiegel R
Tuberculosis Philadelphia : Lippincott Williams & Wilkins, 2004,
— id: 3972, year: 2004, vol: , page: 477, stat: Chapter,

Compliance with anti-reflux therapy in patients with otolaryngologic manifestations of gastroesophageal reflux disease
Giacchi RJ; Sullivan D; Rothstein SG
2000 Jan;110(1):19-22, Laryngoscope
OBJECTIVES: The otolaryngologic manifestations of gastroesophageal reflux include sore throat, throat clearing, sensation of postnasal drip, hoarseness, and globus. This constellation of laryngeal and pharyngeal symptoms can be referred to as laryngopharyngeal reflux (LPR). Many patients with LPR are treated empirically and the results are often rewarding. The objective of this study is to evaluate compliance with antireflux therapy in this patient population. STUDY DESIGN: A prospective analysis of 30 patients referred to an otolaryngology clinic for the above symptoms. METHODS: The patients were treated for LPR using a standardized behavior modification form in combination with medical management. Patient compliance was followed with a patient questionnaire and evaluation of medication renewal from pharmacy records. RESULTS: The patients were followed for an average of 4 months and 80% reported an improvement of their symptoms. Evaluation of patient questionnaires revealed that 50% of patients reported taking their medications as prescribed. Compliance varied widely with regard to behavioral modifications. The degree of symptomatic improvement was significantly correlated with overall compliance with both medications and behavioral changes (Pearson correlation coefficient, P < .05). The individual behavioral changes that were significantly correlated with the reduction of symptoms were avoidance of food and liquid before sleep and elevation of the head of bed, but not food habits. CONCLUSIONS: The treatment plan for gastroesophageal reflux disease requires behavioral modifications and prescription medications that many patients may find difficult to follow. However, those patients who comply with the treatment plan can be expected to have an improvement of their symptoms. Furthermore, simplifying the treatment regimen including those elements most correlated with symptomatic improvement may increase patient compliance
— id: 8576, year: 2000, vol: 110, page: 19, stat: Journal Article,

Selenium and immunocompetence in patients with head and neck cancer
Kiremidjian-Schumacher L; Roy M; Glickman R; Schneider K; Rothstein S; Cooper J; Hochster H; Kim M; Newman R
2000 Feb;73(2):97-111, Biological trace element research
This randomized double-blind placebo-controlled study aimed to determine whether oral intake of 200 microg/d of sodium selenite, a dose within the safe and adequate daily intake (50-200 microg/d) recommended by the U.S. Food and Nutrition Board, will abrogate depressed or enhance normal-level immune functions of patients receiving therapy for squamous cell carcinoma of the head and neck. Subjects were given one selenium/placebo tablet/d for 8 wk, beginning on the day of their first treatment for the disease (e.g., surgery, radiation, or surgery and radiation) and their immune functions were monitored. Supplementation with selenium (Se) during therapy resulted in a significantly enhanced cell-mediated immunue responsiveness, as reflected in the ability of the patient's lymphocytes to respond to stimulation with mitogen, to generate cytotoxic lymphocytes, and to destroy tumor cells. The enhanced responsiveness was evident during therapy and following conclusion of therapy. In contrast, patients in the placebo arm of the study showed a decline in immune responsiveness during therapy, which was followed, in some patients, by an enhancement, but the responses of the group remained significantly lower than baseline values. The data also show that at baseline, patients entered in the study had significantly lower plasma Se levels than healthy individuals, and patients in stage I or II of disease had significantly higher plasma selenium levels than patients in stage III or IV of disease
— id: 27861, year: 2000, vol: 73, page: 97, stat: Journal Article,

Selenium and immunocompetence in patients with head and neck cancer
Schumacher, LK; Roy, M; Glickman, R; Schneider, K; Rothstein, S; Cooper, J; Kim, M; Newman, R
1999 MAR 15 ;13(5):A917-A917, FASEB journal
— id: 53933, year: 1999, vol: 13, page: A917, stat: Journal Article,

Reflux and vocal disorders in singers with bulimia
Rothstein SG
1998 Mar;12(1):89-90, Journal of voice
Dysphonia associated with bulimia has been described in the literature associated with vocal fold edema and polypoid changes. Laryngopharyngeat reflux (LPR) has been documented to cause reflux vocal fold pathology including edema and polypoid changes. We studied eight singers with bulimia and documented vocal fold pathology, including edema, posterior commissure hypertrophy, ventricular obliteration, and telangiectasia. Reflux was demonstrated in all eight. The results of this study showed that LPR may be a contributing factor to vocal disorders in singers with bulimia
— id: 7772, year: 1998, vol: 12, page: 89, stat: Journal Article,

Epiglottic position after cricothyroidotomy: a comparison with tracheotomy
Lim JW; Lerner PK; Rothstein SG
1997 Jul;106(7 Pt 1):560-562, Annals of otology rhinology & laryngology
Dysphagia is a known problem in patients with tracheotomy, but its association with cricothyroidotomy is not well studied. The purpose of this study was to evaluate dysphagia in patients with cricothyroidotomy and to determine if there is a reliable indicator of swallowing dysfunction in these patients. A review of charts for patients with modified barium swallow studies conducted at the New York University Medical Center Swallowing Disorders Center yielded three groups of patients: patients with cricothyroidotomy, patients with tracheotomy, and normal patients. There were 8 patients in each group. In all patients in the cricothyroidotomy group, there was a greater impairment of epiglottic displacement, laryngeal elevation, and upper esophageal opening than in the tracheotomy group. This problem with epiglottic displacement produced susceptibility to laryngeal penetration and, in turn, increased the risk of aspiration in those patients with cricothyroidotomy. After cricothyroidotomy tube removal, a return to normal epiglottic movement was observed within 2 months. One mechanism of swallowing dysfunction is impaired posterior displacement of the epiglottis over the glottic aperture. This impaired epiglottic motion appears to be related to restricted laryngeal elevation secondary to tethering of the larynx anteriorly at the site of the cricothyroidotomy. Additionally, we noted a decrease in the opening of the upper esophageal sphincter
— id: 7199, year: 1997, vol: 106, page: 560, stat: Journal Article,

Madelung's disease: case reports and literature review
Kohan D; Miller PJ; Rothstein SG; Kaufman D
1993 Feb;108(2):156-159, Otolaryngology, head & neck surgery
— id: 13257, year: 1993, vol: 108, page: 156, stat: Journal Article,

Squamous cell carcinoma in HIV-positive patients under age 45
Roland JT Jr; Rothstein SG; Mittal KR; Perksy MS
1993 May;103(5):509-511, Laryngoscope
Eight patients 45 years of age and under (range, 29 to 45) with squamous cell carcinoma of the head and neck and infection with the human immunodeficiency virus are reported. Primary tumor sites include nasopharynx, oral cavity, oropharynx, and larynx. Probes for the human papillomavirus were positive in two of the patients. Therapy consisted of surgery followed by radiation therapy in five patients, surgery alone in one patient, and radiation therapy in the remaining two patients. Follow-up ranged up to 2 years and revealed four deaths, three patients alive without disease, and one patient recently posttreatment with residual disease. The significance of the presence of the human papillomavirus in these individuals remains to be determined. The incidence of squamous cell carcinoma of the head and neck under age 45 is low, and whether there may be a higher incidence in HIV-positive patients cannot be determined from this small series
— id: 13174, year: 1993, vol: 103, page: 509, stat: Journal Article,

Squamous cell carcinoma in older patients without risk factors
Constantinides MS; Rothstein SG; Persky MS
1992 Mar;106(3):275-277, Otolaryngology, head & neck surgery
Ten patients over sixty years of age with no history of tobacco or alcohol use were treated for squamous cell carcinoma of the upper aerodigestive tract between 1979 and 1991. Nine of these ten patients were women with lesions confined to the oral cavity and oropharynx. Modes of treatment included surgery, radiation, or a combination of surgery and radiation. Followup from 1 to 10 years revealed two deaths from local and distant spread, and eight patients with no evidence of disease. Recurrences after treatment were aggressive and occurred within the same region as the primary lesion. Although most patients with upper aerodigestive squamous cell carcinoma are men with alcohol and/or tobacco exposure, this study demonstrates findings consistent with field cancerization in a group of older women with no risk factors
— id: 13664, year: 1992, vol: 106, page: 275, stat: Journal Article,

SINUS DISEASE IN THE IMMUNOCOMPROMISED HOST
KOHAN, D; SKORINA, JMG; JACOBS, JB; LEBOWITZ, A; ROTHSTEIN, SG
1992 MAY-JUN ;6(3):115-118, American journal of rhinology
Sinusitis in the immunocompromised person can be a fulminant or even fatal illness. Aggressive treatment with intravenous antibiotics and surgery is often warranted. We report 13 cases of sinusitis in immunocompromised patients who, having failed medical treatment, required surgical management of their sinus disease. Among the patients whose sinuses were cultured intraoperatively, 63% grew Staphylococcus aureus. Most of the patients showed improvement in their infections, and none had complications of surgery
— id: 51883, year: 1992, vol: 6, page: 115, stat: Journal Article,

Bulimia: the otolaryngology head and neck perspective
Rothstein SG; Rothstein JM
1992 Feb;71(2):78-80, Ear, nose & throat journal
Bulimia nervosa is an eating disorder found predominantly in young females and characterized by binge-purge cycles as well as medical and psychological problems. The patient with bulimia may present to the otolaryngologist with an upper aerodigestive complaint. It is of paramount importance that the otolaryngologist be cognizant of the disease in order to refer the patient for further therapy
— id: 13700, year: 1992, vol: 71, page: 78, stat: Journal Article,

Extracranial repair of cerebrospinal fluid otorhinorrhea
Persky MS; Rothstein SG; Breda SD; Cohen NL; Cooper P; Ransohoff J
1991 Feb;101(2):134-136, Laryngoscope
Forty-eight patients with cerebrospinal fluid leaks comprise this retrospective study. There were 39 traumatic and 9 spontaneous leaks. Nine patients were initially managed with bed rest and spinal drainage, but 3 patients in this group ultimately required surgical intervention for repair of their persistent leaks. Thirty-nine patients had surgery as initial therapy, with 33 extracranial repairs, 2 intracranial repairs, and 4 combined approaches. The extracranial approach was used in 36 of 42 patients, with an initial success rate of 86%
— id: 14139, year: 1991, vol: 101, page: 134, stat: Journal Article,

Emergencies in AIDS patients: the otolaryngologic perspective
Rothstein SG; Schneider KL; Kohan D; Persky MS; Holliday R
1991 Apr;104(4):545-548, Otolaryngology, head & neck surgery
— id: 14082, year: 1991, vol: 104, page: 545, stat: Journal Article,

Hemostasis in laryngoscopy
Rothstein, S G
1991 Jan;70(1):55-56, Ear, nose & throat journal
— id: 106393, year: 1991, vol: 70, page: 55, stat: Journal Article,

Hemostatis in laryngoscopy
Rothstein, S G
1991 May;70(5):324-325, Ear, nose & throat journal
— id: 106391, year: 1991, vol: 70, page: 324, stat: Journal Article,

Crack smiles
Rothstein, S G; Gittelman, P; Persky, M S
1991 Mar 27;265(12):1528-1528, JAMA
— id: 106392, year: 1991, vol: 265, page: 1528, stat: Journal Article,

EXTRACRANIAL REPAIR OF CEREBROSPINAL-FLUID FISTULAS - TECHNIQUE AND RESULTS IN 37 PATIENTS
Mccormack, B; Cooper, PR; Persky, M; Rothstein, S
1990 Sep;27(3):412-417, Neurosurgery
— id: 31855, year: 1990, vol: 27, page: 412, stat: Journal Article,

Esophageal intubation for nasogastric tube insertion
Rothstein, S G; Schneider, K L
1990 May;69(5):361-361, Ear, nose & throat journal
— id: 67498, year: 1990, vol: 69, page: 361, stat: Journal Article,

BENIGN LYMPHOEPITHELIAL CYST OF THE PAROTID IN HIV INFECTED MEN AND MEN AT RISK FOR AIDS - IMMUNOPHENOTYPIC STUDY OF THE LYMPHOID AND EPITHELIAL COMPONENTS
FINFER, MD; CHIRIBOGA, LA; SCHINELLA, RA; ROTHSTEIN, SG; FEINER, HD
1989 ;60(Suppl 1):A28-A28, Laboratory investigation
— id: 51453, year: 1989, vol: 60, page: A28, stat: Journal Article,

THE BENIGN LYMPHOEPITHELIAL CYST - REPORT OF FINDINGS IN 23 PATIENTS WITH DISCUSSION OF ITS RELATION TO HUMAN IMMUNODEFICIENCY VIRUS-INFECTION AND TO ACQUIRED IMMUNODEFICIENCY SYNDROME RISK-FACTORS
FINFER, MD; SCHINELLA, RA; ROTHSTEIN, S; FEINER, H
1989 ;60(Suppl 1):A28-A28, Laboratory investigation
— id: 51454, year: 1989, vol: 60, page: A28, stat: Journal Article,

Epiglottitis in AIDS patients
Rothstein SG; Persky MS; Edelman BA; Gittleman PE; Stroschein M
1989 Apr;99(4):389-392, Laryngoscope
Adult epiglottitis in patients with acquired immunodeficiency syndrome has not been previously reported. A pale, floppy epiglottis with supraglottic edema, cervical lymphadenopathy, a normal to low white blood count without a shift to the left, and rapidly progressive airway obstruction characterize this entity. In this small series of patients, conservative medical management was not successful, and aggressive airway intervention with appropriate intravenous antibiotic therapy was necessary
— id: 10671, year: 1989, vol: 99, page: 389, stat: Journal Article,

Instant slides of radiographs for lectures
Rothstein SG; Stewart PL
1989 Oct;101(4):506-506, Otolaryngology, head & neck surgery
High quality slides of radiographs may be made with a simple, fast, and inexpensive technique using Kodak Rapid Process Copy film. Lecture presentations may include a slide of a pertinent plain radiograph, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Although these slides may be made with a 35 mm SLR camera and flash or with a 35 mm SLR camera and a lighted viewbox, an alternative method is available that is easy to perform, inexpensive, and can produce quality slides in as little as 30 minutes
— id: 10490, year: 1989, vol: 101, page: 506, stat: Journal Article,

The use of Gore-Tex implants in nasal augmentation operations
Rothstein, S G; Jacobs, J B
1989 Sep;:40, 42, 44-5, Ear, nose & throat journal
— id: 106394, year: 1989, vol: , page: 40, 42, 44, stat: Journal Article,

Cystic parotid lesions in patients at risk for the acquired immunodeficiency syndrome
Finfer MD; Schinella RA; Rothstein SG; Persky MS
1988 Nov;114(11):1290-1294, Archives of otolaryngology, head & neck surgery
Twenty-three patients at risk for the acquired immunodeficiency syndrome presented with cystic lesions of the parotid gland. Fourteen patients had unilateral parotid cysts and nine had bilateral enlargement. Ten patients were positive for antibodies to the human immunodeficiency virus (HIV), three were negative for antibodies to the human immunodeficiency virus, and ten refused testing. Fine-needle aspiration cytology and computed tomography were helpful in making the diagnosis of benign lymphoepithelial cyst. Superficial parotidectomy confirmed the diagnosis. Concurrent malignancy (Kaposi's sarcoma) was diagnosed in one patient from a parotid specimen. Follow-up has ranged from four months to five years
— id: 10907, year: 1988, vol: 114, page: 1290, stat: Journal Article,

Benign lymphoepithelial parotid cysts and hyperplastic cervical adenopathy in AIDS-risk patients: a new CT appearance
Holliday RA; Cohen WA; Schinella RA; Rothstein SG; Persky MS; Jacobs JM; Som PM
1988 Aug;168(2):439-441, Radiology
The contrast material-enhanced computed tomographic (CT) scans of 18 patients at risk for acquired immunodeficiency syndrome (AIDS) who had painless facial swelling were reviewed. All scans demonstrated parotid cysts and diffuse homogeneous cervical adenopathy. The cysts were bilateral in all but three cases. Eleven of 13 patients tested had antibodies to the human immunodeficiency virus (HIV), and two of the five untested patients later developed AIDS. The authors believe that the CT findings of multiple parotid cysts and cervical adenopathy suggest that the patient may be infected with the HIV virus, and the radiologist should alert the referring physician so that appropriate precautions and treatment may be initiated
— id: 11000, year: 1988, vol: 168, page: 439, stat: Journal Article,

Otologic disease in patients with acquired immunodeficiency syndrome
Kohan D; Rothstein SG; Cohen NL
1988 Nov-Dec;97(6 Pt 1):636-640, Annals of otology rhinology & laryngology
A 5-year retrospective study evaluating otologic disease in patients with acquired immunodeficiency syndrome (AIDS) was conducted at the New York University Medical Center-Bellevue Hospital Center. Twenty-six patients with documented otologic disease who met the Centers for Disease Control criteria for AIDS were identified and their charts were analyzed according to presenting complaints, physical examination, diagnostic modalities, pathologic condition, management, and outcome. A marked diversity of otologic diseases of varying severity was noted. The majority of patients complained of hearing loss and otalgia during their hospitalization for treatment of AIDS-related opportunistic infections. The most frequent diagnoses were otitis externa, acute otitis media, and otitis media with effusion. Sensorineural hearing loss frequently appeared to be related to ototoxic medications and neurologic infections
— id: 10896, year: 1988, vol: 97, page: 636, stat: Journal Article,

Evaluation of malignant invasion of the carotid artery by CT scan and ultrasound
Rothstein SG; Persky MS; Horii S
1988 Mar;98(3):321-324, Laryngoscope
Carcinoma adherent to the carotid artery may be present in advanced head and neck cancers. Angiography, ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI) are available for the preoperative evaluation of the carotid artery. This study demonstrates that CT is not accurate in demonstrating malignant invasion of the carotid artery. Ultrasonography appears to be the best modality for assessing carotid artery invasion. Magnetic resonance imaging may prove helpful in this determination
— id: 11171, year: 1988, vol: 98, page: 321, stat: Journal Article,

Atypical presentation of lymphomatoid papulosis as a neck mass
Rothstein, S G; Schneider, K L
1988 Apr;67(4):252, 254-5, Ear, nose & throat journal
— id: 67499, year: 1988, vol: 67, page: 252, 254, stat: Journal Article,

Carotid sinus hypersensitivity secondary to parapharyngeal space carcinoma
Rothstein, S G; Jacobs, J B; Reede, D L
1987 Jul-Aug;9(6):332-335, Head & neck surgery
Carotid sinus hypersensitivity secondary to the presence of head and neck carcinoma has been recently reviewed in the otolaryngologic literature. We present a case of carotid sinus hypersensitivity coupled with glossopharyngeal neuralgia due to tonsillar carcinoma invading the parapharyngeal space. Medical management with atropine, carbamazepine, and transvenous pacing was only moderately successful in controlling the symptomatology. Surgery appeared to offer a more permanent solution to the problem
— id: 106395, year: 1987, vol: 9, page: 332, stat: Journal Article,