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John Craig, MD Profile
John Craig, MD

@JohnCraigNose

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Rhinologist at Henry Ford Health; I might like noses, sinuses, and the skull base

Detroit, MI
Joined March 2017
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@JohnCraigNose
John Craig, MD
2 years
Feeling odontogenic? Let’s hit this point home. Patient got a molar extracted. No sinus symptoms and normal nasal endo. CT read: periapical bone expanded and dehisced, adjacent maxillary sinusitis. NOTE: this is reactive sinus mucosal thickening, NOT #ODS . @ent_ams @henryfordent
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@JohnCraigNose
John Craig, MD
2 years
Ask about sidedness of sinus symptoms! Non-ENT doctor: "I'm sending you someone w recurrent sinusitis that won't clear after 3 antibiotics." Me: "Symptoms unilateral by any chance?" Doctor: "I didn't ask." Interval CT: odontogenic sinusitis. #ODS @ent_ams @henryfordent
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@JohnCraigNose
John Craig, MD
2 years
Was thinking of new topics to post, but this is my first clinic patient of the day…come on! Can’t help it…Carpe Diem!👃🏼🦷✊🏻🧐🤓 @henryfordent #MedTwitter @ent_ams
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@JohnCraigNose
John Craig, MD
1 year
Check out the unique growth pattern of this JNA. It grew into the sphenoid sinus, and separately into the pterygoid body. Tripped me out seeing the Vidian ABOVE me during surgery :) Video will be made/shared, once talks for upcoming @AmRhinoSociety and #OTOMTG23 are tidied up!
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@JohnCraigNose
John Craig, MD
3 months
Catching up on CT results from last week’s vacation, and here’s a gem showing that there’s still a role for spreading #ODS gospel. Note the read at end. Something fascinating about doctors’ 👀 not wanting to rotate downward just a tad when seeing this pattern of sinus opac on CT.
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@JohnCraigNose
John Craig, MD
11 months
I saw some X-chatter about that #JNA case, so I made the video . It's a tad longer than usual, but hopefully helpful to someone. Not the biggest #JNA , but unique growth pattern, and highlights key surgical concepts. @AsmaroMD will be licking his chops for
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@JohnCraigNose
John Craig, MD
9 months
Not simple, but no need to make repairing #olfactoryneuroblastoma #skullbase defects terribly complex. If you have synthetic collagen grafts, no need for thigh or abdominal incisions for fat/fascia. Synthetic inlays intradurally and epidurally plus large nasoseptal flap =
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@JohnCraigNose
John Craig, MD
2 years
Symptomatic, so game on. AEA flap should do the trick.👃🏼💪 @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
2 years
If you can’t keep this frontal sinus open, just hand in your rhinologist card…👃🏼 🏷️ @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
2 years
Ah the effects of sinus scarring in someone who didn't need the sinus surgery that led to this ethmoid mucocele and recurrent orbital preseptal cellulitis. Looks minor, but was a tricky frontal to open; now I have to keep it open :) @henryfordent #medtwitter #sinussurgery
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@JohnCraigNose
John Craig, MD
8 months
No more #skullbase pts in-house, time to fine-tune talk for #NASBS2024 ! If you're heading to #ATL this wkd for #NASBS2024 , and looking for 8 min of #craniopharyngioma RECON Sat AM, come hang! Humbling and gratifying, the story of #skullbase surgery! @AsmaroMD @jakeeide1
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@JohnCraigNose
John Craig, MD
9 months
Happy 2024. Let's start off with a consult from this week. Pt referred by ENT for sinus "cancer" based on 1st CT here. Endo showed PUS, not a mass. We got a better CT, and she had an MRI scheduled already, so check it out! Let's just say, pt is relieved! Sounds easy, but plenty
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@JohnCraigNose
John Craig, MD
6 months
Welcome @Rayan_alfallaj for a quick glimpse into the rhinologic chaos here @henryfordent ! Big week of #IFS , clinic insanity, likely #ODS , skull base with @AsmaroMD , and annual resident dissection course with @ekqibajiu guest speaker. Game on! 👃🏼 ✊🏻 @DrAmritaRay
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@JohnCraigNose
John Craig, MD
10 months
Long post, sorry. To those just starting practice or soon to be, thought it’d be cool to discuss HOW to go about trying NEW surgical techniques or maneuvers you never learned in training. My 2 cents after 8.5 yrs in the game on steps to consider when you identify limits in your
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@JohnCraigNose
John Craig, MD
1 year
Fun Medtronic Skull Base 360 course by @drvijay_agarwal . Making complex learning fun is what it’s all about! We ate 24 oz steaks and some drank beer-ritas. Pat Colley, @DrMichaelJLang @DavidAltschulMD @henryfordent
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@JohnCraigNose
John Craig, MD
11 months
The @aboutKP games are soon to begin! Pumped for academic game day in LA w @zarapatel_md to talk primary and revision sinus surgery, olfaction, and good old #ODS . Let’s go! @henryfordent
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@JohnCraigNose
John Craig, MD
3 years
And Henry Ford takes it! Congrats to our residents winning the 2022 Trio Resident Bowl! @henryfordent #medtwitter #winnerswin
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@JohnCraigNose
John Craig, MD
1 year
One reason Onodi cells can be so naughty. People worry about the optic nerve, ok fine :), but can also make you miss the actual sphenoid! Pt w PND from sphenoid, prior surgeon said ‘but I already opened your sinuses’ so kept giving abx. Fail. Easy win for sphenoidotomy tho! 😂
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@JohnCraigNose
John Craig, MD
6 months
Raise your hand if you need chaos in your life.🙋🏻‍♂️ Really needed to finish some papers. Sat down, motivation rising by 0645, resident text at 0700: ‘left-sided complete vision loss over last 24-48 hrs with orbital apex syndrome’ with this scan. What would a research day be without
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@JohnCraigNose
John Craig, MD
9 months
Why collaborate w a H/A specialist? Take this pt. 40 F w ongoing LEFT FH pains. Pretty clear CT and an ENT does a balloon sinuplasty. No better. Next ENT figures they didn’t open sinuses wide enough so does a nice sinus surgery (below). NO BETTER. I see, refer to H/A specialist:
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@JohnCraigNose
John Craig, MD
17 days
Not gonna lie, pretty cool shots here w 70 deg scope. This is lateral recess #encephalocele case I posted last month. Staying extraperiosteal to preserve #PPF contents is the way! @henryfordent @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
2 years
For those pursuing academics, don't forget to build the family CV in parallel to the work CV. My work desk pictures are my attempt at reminding me about what's important. 30 sec later I notice another patient arriving, and my email's blown up 5 times.🧐 @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
1 year
When does a deviated septum become caudal? Who should tackle these? What approach? What are the real outcomes?We’ll hear from rhinoplasty experts at #HFSNS4 about cases like this! @henryfordent #notallseptumsarecreatedequal
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@JohnCraigNose
John Craig, MD
1 year
Happy Thur. 1st case, I still enjoy catching these on preop CT review. Even @AsmaroMD enjoys a good Onodi (or a naughty) cell. May your rhinologic Thursdays be filled w clear views and sharp thru-cuts.✌🏻😷 @henryfordent @jakeeide1 @DrAmritaRay
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@JohnCraigNose
John Craig, MD
5 months
Seen a posterolateral nerve before? They're really big, and easy to harvest (NOT!). Whether this ends up just being another posterior nasal nerve in the future, the next 6-12 months will tell...🧐😎😪 @henryfordent @MakaryENT @ent_ams @jakeeide1
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@JohnCraigNose
John Craig, MD
5 months
I didn't order all these images, but makes for a nice post on nasal #CSF leak diagnosis. Shows that in the end, confirming with #B2Tf and localizing with #CT is usually all you need. Then close with a #FMG marked on mucosal side w/ a smiley face that turned frowny or
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@JohnCraigNose
John Craig, MD
8 months
This is coming for me tomorrow. There’s no avoiding it, just gotta embrace it. Game the *** on…😎😂 Large #nasalseptalperforations are humbling, but I think our field is making legit strides on these. Multicenter collabs coming in 2024-25! @henryfordent @MakaryENT @LeighSowerby
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@JohnCraigNose
John Craig, MD
2 years
Hard to beat these cases. FYI, I don't open maxillary sinuses this way, this was just for the show. 🤫😎 Surgeons hopefully assess for this before surgery, but if not, and you see sinuses that look like this intraop, get the teeth checked! #ODS @henryfordent #medtwitter @ent_ams
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@JohnCraigNose
John Craig, MD
1 year
#ODS Friday. Prior balloon sinuplasty for ODS after extracton 6 mon ago, maybe seeded the undiseased sphenoid sinus? 6 mon later... cav sinus thrombosis and epidural abscess! She's good now tho. Maxillary antrostomy with saline flushing might have prevented this.🧐 @henryfordent
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@JohnCraigNose
John Craig, MD
2 years
Bilateral oh (so) naughty cells coming up next case! Let's get this trending!😂 @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
11 months
Saw 2 really interesting consults yesterday that make me think not everyone knows the importance of nasal endoscopy in diagnosing #ODS , but that's what X is for! Check these out. Both patients had prior root canals, both referred for #ODS . See the difference? 😎🦷👃 @ent_ams
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@JohnCraigNose
John Craig, MD
5 months
Concerning that this excited me in clinic? Provided some KEY points on #ODS diagnosis. Pus on left: #ODS ; NO pus on right: NO #ODS . Both sides need dental treatment. #itsallaboutthepus 😎🦷👃🪄 @ent_ams @MartaKwiat_ska @MakaryENT @henryfordent
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@JohnCraigNose
John Craig, MD
3 years
Took odontogenic sinusitis to the local Detroit bar scene last night (for the Oakland County Young Dentists Society). I learn how little I know about teeth, they learn how little they know about sinuses. The beauty of #collaboration . Love #ods ! @henryfordent @ent_ams #MedTwitter
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@JohnCraigNose
John Craig, MD
1 year
This was a fun one. 4 yrs, prospective. Just came online. Atrovent is amazing for watery rhinorrhea 😪. CSF is watery too 🤔 Atrovent response as a screening test? YES! Check out the proposed paradigm; try it out! @jakeeide1 @henryfordent @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
11 months
Another Sunday Cadaveric Fun Day was had by me, @jakeeide1 and Maddy G from @henryfordent . Even with decent posture, sore backs have ensued, but findings were worth it! @LeighSowerby in the mix on some of the work too! Coming to @AmRhinoSociety Miami fall 2024! 🔥👃🏼
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@JohnCraigNose
John Craig, MD
1 month
Well it's out there now! To be clear, this is NOT saying maxillary antrostomy alone is better than complete sinus surgery for #ODS , just that it's an OPTION. So maybe someone has tough frontal anatomy, or you aren't as comfortable with frontal surgery. This gives patients and
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@JohnCraigNose
John Craig, MD
2 years
I think the world would be an ever so slightly better place if all doctors knew to prescribe Ipratropium nasal spray (Atrovent) for thin clear nasal drainage. 😪😎 #medtwitter @henryfordent (for real though, there's good evidence to support this)
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@JohnCraigNose
John Craig, MD
3 months
Can’t beat this (again this week). JUST LOOK DOWN! Might be an #ODS T-shirt some day. 🦷 👕. So easy, so powerful. 🔥 @henryfordent @ent_ams @MartaKwiat_ska @jakeeide1 @MakaryENT
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@JohnCraigNose
John Craig, MD
2 years
Whoever developed silver nitrate sticks, just know you help stop 200-250+ outpatient nosebleeds a year in my practice alone around Detroit, MI! Do some rough math, and that’s some IMPACT! Epistaxis is so gratifying. ✊🏻 @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
3 years
Dr. Will Mason went through 3000 of my charts over 5 yrs to determine how often unilateral clear nasal drainage was a brain fluid leak...30%. Nonallergic rhinitis represented 50%! Is this what you expected? 😪💪 #medtwitter @henryfordent ⁩ ⁦ @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
1 year
Headache specialists feel the same as we do! HUGE problem for society. Wild overdiagnosis of sinusitis, tons of unnecessary abx and other treatments given for this. And yes, we have the data to show it. It’s coming maybe in 2024-25! 💆🏼‍♂️😎 @henryfordent @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
6 months
#Mucor . Decently controlled DM (Glc running 150-190, still a risk!) Pretty weird finding with a #mucor fungal ball per frozen section, but def #mucor in the mucosa. Hopefully caught soon enough to prevent #cavernoussinus spread. Time for antifungals and insulin to work their
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@JohnCraigNose
John Craig, MD
6 months
And we’re off! Love having next level discussions about the ‘basics.’ Talking anatomy and surgical techniques at our annual resident dissection course from nose to brain here @henryfordent and @HenryFordNeuro ; dorking out with me, @DrAmritaRay , @ekqibajiu , and @AsmaroMD
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@JohnCraigNose
John Craig, MD
2 years
Another year of the @henryfordent resident sinus dissection course in the books. Solid. Much respect to our phenomenal guest speaker @davidgudismd . It was a breeding ground for excellence! @DrAmritaRay #MedTwitter
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@JohnCraigNose
John Craig, MD
4 months
Working on one of these #OtoClinics #OCNA chapters for our #ODS issue coming later this year. Looking for the perfect figures to spice things up, and came across this gem from years ago (but probably won't be in the book). Just so good at teaching that continuity between a
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@JohnCraigNose
John Craig, MD
6 months
Thinking about rhinologic operative miracles again 👃🏼 🪄. Here’s a starter list, curious what other 👃🏼 miracles people see: 1. Successful #septalperforation repair 2. Long-term resolution of clear thin rhinorrhea after posterior nasal neurectomy 😪 (I know, some recur, much to
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@JohnCraigNose
John Craig, MD
1 year
Bilateral frontal sinus #osteomas in young patient. Likely Gardner's Syndrome. Bring your patience and numerous 30K burs! Aim for complete osteoma resection, and refer to GI for colonoscopy @henryfordent
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@JohnCraigNose
John Craig, MD
8 months
Nice stop at @Triological #Trio2024 in W Palm Beach. Chill little poster here, the paper will be cool. Props to @MartaKwiat_ska , Japnam Jassal, and @jakeeide1 . 20 cadaveric denkers, extractions of upper teeth, plus 100 CT scans to review B/L; mildly tedious! But now we know where
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@JohnCraigNose
John Craig, MD
2 years
1st team dinner last night. Terrible picture lighting. But welcome @jakeeide1 to the @henryfordent Rhinology show w me and @DrAmritaRay . Nothing like discussing over drinks who uses antibiotics or steroids after sinus surgery! It's a bright rhinologic future! #medtwitter
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@JohnCraigNose
John Craig, MD
11 months
Not gonna lie. Today was pretty awesome. @zarapatel_md and I got to talk #sinussurgery and research passions 🧐😎. Her work w olfaction is inspiring. Being on the docket with her was next level 🔥. Thanks again @aboutKP , Fred Yoo, and Rohit Garg for having us! @henryfordent
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@JohnCraigNose
John Craig, MD
10 months
Just got this scan on someone with intermittent right-sided diplopia with up-gaze. On exam, just barely right-sided hypoglobus. Also has recurrent infectious sinusitis. Yes game on, but think about the frontal approach for this #osteoma . I'm def going endoscopic, video should be
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@JohnCraigNose
John Craig, MD
3 years
Shout out to my next new rhinologic partner, Dr. Jake Eide, who just presented their work from @PennRhinology at @NASBSorg . Growth coming to @henryfordent and @HenryFordNeuro ! 👃🏼 💀 #medtwitter
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@JohnCraigNose
John Craig, MD
1 year
Even if you're annoyed by repeated #ODS posts, come on, this disease produces cool images. #Papillaryedema in setting left maxillary ODS from OAF. It's not 100% specific to #ODS , but it's very suspicious! Watch for it! @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
2 years
I know many people know this, but this problem after sinus surgery for polyps is largely preventable if you just safely remove the structures pointed at by arrows. 😎 @jakeeide1 @ent_ams @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
1 year
Went to bed last night after practicing my talk for this morning on NAR, and def one of the cuter things my 7 y/o daughter has done for me…also, watch out for an increased role of surgeons as years march on for NAR! @henryfordent #rhinitis #medtwitter
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@JohnCraigNose
John Craig, MD
3 years
Putting some mental energy into a nasal obstruction talk, but saving plenty for the halftime show today! #superbowlhalftimeshow #eminem @henryfordent
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@JohnCraigNose
John Craig, MD
1 year
Ok, maybe too many tweets this week, but I wanted to share before and after pics of myself after @jakeeide1 and I just got this systematic review accepted today to @ifar_journal ! Was a journey. ‘Reasons for false B2Tf testing for CSF.’ (Not in eprint yet) More coming from us on
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@JohnCraigNose
John Craig, MD
1 year
So rare to get the 3 of us together in one room. Team Rhinology at @henryfordent strategerizing with @HenryFordNeuro to the future; lots happening w/ upcoming #HFSNS4 on 8/25 and inaugural Pituitary Symposium 10/25 👊🏻✊🏻👃🏼💀
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@JohnCraigNose
John Craig, MD
2 years
I'm not in Dallas yet, but props to @akassab24 for repping this #ODS project at @__COSM @AmRhinoSociety and his photoshop skills! #postersmatter too :) @henryfordent #medtwitter @ent_ams
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@JohnCraigNose
John Craig, MD
4 years
Want to learn a systematic way to diagnose odontogenic sinusitis? Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement #ent #dentistry #sinusitits
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@JohnCraigNose
John Craig, MD
1 year
It’s coming… just under 24 hrs out until my #ODS talk at #OTOMTG23 where you’ll see why I think #ODS is amongst the most exciting types of sinus disease. You can throw tomatoes if you want, but stay the whole time and see if you get a few useful tips! @ent_ams @henryfordent
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@JohnCraigNose
John Craig, MD
2 years
I don't how many are repairing lateral recess encephaloceles this way, but it's the way to go. No need to dissect through the PPF! Props to Cleveland Clinic for publishing on it too. @TroyWoodardMD @henryford #Medtwitter
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@JohnCraigNose
John Craig, MD
10 months
I’m reviewing a manuscript. The authors tried to slide an incidence by the readers and cited a source. Checked the reference. NO WAY that paper showed the incidence. Can’t tell you how often I see this. Not good. I know the feeling when writing, you might be holding on by a tiny
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@JohnCraigNose
John Craig, MD
2 months
Other than jet lag, really cool being in #Singapore at #SARC14 meeting. Dorking it out about #ODS AND #rhinitis this week. Lots of updates coming this next year! @henryfordent
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@JohnCraigNose
John Craig, MD
2 years
Team Rhinology at @henryfordent . I'm the old guy now. Lots coming from the 👃🏼 in Detroit! Dr. Jake Eide (right) is slow to adopt Twitter, but he'll figure it out. @DrAmritaRay #Medtwitter @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
7 months
Feels like an #ODS kind of week. I saw this Friday. Great example of how to manage #ODS due to #apicalperiodontitis . Follow the SYMPTOMS first. She was somehow ASYMPTOMATIC, and had medical issues, so I sent to endodontist for eval and possible #rootcanal (s) versus
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@JohnCraigNose
John Craig, MD
6 months
Came across this picture in my phone. Ever seen a dilated superior ophthalmic vein (arrows) in #CST (cavernous sinus thrombosis)? It’s a classic imaging finding to watch for, esp with a proptotic chemotic eye. @henryfordent @HenryFordNeuro @AsmaroMD @DrAmritaRay
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@JohnCraigNose
John Craig, MD
3 years
Future neurosurgical partner ⁦ @AsmaroMD ⁩ delivering a really cool talk on endoscopic approaches to the cavernous sinus. Foreshadowing of great things to come! ⁦⁩ #medtwitter @henryfordent ⁩ ⁦ @HenryFordNeuro
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@JohnCraigNose
John Craig, MD
1 year
Haven’t finished the slide just yet, but if you think #ODS is just ‘sinusitis from a tooth infection,’ I’m sorry to disappoint. Numerous scenarios here, and these aren’t even all of them, and each is technically a little different! If in Nashville, check out my talk on Wed! Gonna
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@JohnCraigNose
John Craig, MD
1 year
And we’re off! Props to @AsmaroMD and @jakeeide1 for getting a new era of pituitary symposia started at @HenryFordNeuro @henryfordent . Starting w evolution of skull base surgery to new age of pituitary surgery. Game on!
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@JohnCraigNose
John Craig, MD
1 year
Just discussed recalcitrant infectious sinusitis despite good sinus surgery in immunocompetent pts. Can be humbling. Message: we try our damndest, and not every case ends up perfect; but we keep at it until symptoms are tolerated. Often not quick fixes! @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
1 year
Who needs some #ODS ? Just saw this in clinic. 1 yr ago pt had dental pain + mild L-sided sinusitis sxs, got root canal and all sxs resolved; then recurred 1 mon ago with gum/buccal abscess. Gets I&D + revision root canal. Still with mild PND and foul smell. No dental pain. Abx?
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@JohnCraigNose
John Craig, MD
2 years
More cases to be discussed at the 3rd annual #HFSNS on Fri 10/7. When does an anterior septal deviation become cauda? Rhinologist or Rhinoplasty surgeon? Plenty to discuss on managing these, and why failures arise. Register! @henryfordent #MedTwitter
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@JohnCraigNose
John Craig, MD
1 year
Just another #ODS Monday (sing the tune). Patient is symptomatic but not keen on sinus surgery. Could root canal save the day? Lots of #ODS clinical concepts at play here! Might still need sinus surgery, but did you know root canal is an option? Did you know maxillary molars have
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@JohnCraigNose
John Craig, MD
2 years
7 hours of Rhinologic glory coming from Detroit at @henryfordent and virtually on Webex in just 2 months (Fri Oct 7). See promo video and the link to register. Free for trainees, $20 for faculty: 5 CME, and free entry to after party! #HFSNS #MedTwitter
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@JohnCraigNose
John Craig, MD
1 year
So many variations on the theme. Love it. Cx’s from each side could be cool to see too. ✊🏻
@MartaKwiat_ska
Marta Kwiatkowska, MD, PhD
1 year
Another cool #ODS case, with #periapical lesion on the right side but polyps on the left… is it #CRS with #ODS combined?🤔 Definitely I will be looking for #papillaryedema , maybe will guide towards the diagnosis @JohnCraigNose @WIMWarszawa
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@JohnCraigNose
John Craig, MD
2 years
Oh I’ve got a good one here. Is it unilateral or bilateral odontogenic sinusitis ( #ODS )? Watch to the end :) #scopefindingsmatter #culturesCANmatter @henryfordent #medtwitter (spoiler will come later)
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@JohnCraigNose
John Craig, MD
1 year
And we’re off! Game on! #HFSNS @henryfordent #medtwitter
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@JohnCraigNose
John Craig, MD
20 days
Some surgeons are still going after maxillary #sinus #IP w open approaches. Not saying it can’t work, but this case shows possible downstream effects of inadequate resection (13 attempts!), plus an open #Denkers ! Endoscopic visualization can’t be overstated (last image is my 12
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@JohnCraigNose
John Craig, MD
10 months
Case 1 of 3 today. Easy, right? :/ Draf IIIs are great, but this patient is in for a ‘few’ postop follow-ups to keep this patent, game ON! (In case someone’s wondering, I’ll be free grafting the anterior table plus silastics to that and post table) @henryfordent
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@JohnCraigNose
John Craig, MD
3 months
Happy 4th! 🇺🇸 Apparently this is my 1000th post. Crazy. Yes I need more hobbies. Since @ent_ams and I have been delving DEEPLY into the nebulous world of dental disease and treatments for #ODS for upcoming #OCNA issue, figured I’d share a little diagram I drew in the OR,
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@JohnCraigNose
John Craig, MD
1 year
Back in action in the D. Next case…hmmmmm @henryfordent @ent_ams @MakaryENT
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