Αναζήτηση αυτού του ιστολογίου

Πέμπτη 6 Μαΐου 2021

The application of venous nerve conduit trap in the immediate repair and reconstruction of facial nerve in parotid gland tumor: an attempt of a new technique

xlomafota13 shared this article with you from Inoreader

Eur Arch Otorhinolaryngol. 2021 May 4. doi: 10.1007/s00405-021-06732-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To introduce the application of venous nerve conduit in the immediate repair and reconstruction of facial nerve in parotid gland tumor.

METHODS: Three patients with parotid gland tumor in Sichuan Provincial Cancer Hospital were reviewed. All patients were found that the tumor encased and invaded the facial nerve which was difficult to be separated during the operation when all patients were treated with facial nerve repair and reconstruction with the venous nerve conduit trapping technique.

RESULTS: After 1-year follow-up, all patients recovered well in facial nerve function.

CONCLUSION: The venous nerve conduit trapping technique is an effective attempt in the immediate repair and reconstruction of facial nerve in parotid gland tumor, but it needs to be further confirmed by multiple studies.

PMID:< a href="https://pubmed.ncbi.nlm.nih.gov/33948682/?utm_source=Inoreader&utm_medium=rss&utm_content=1dKORAZbU5vxmu8AJAeyXPJqUEPUheKpin0OrtWyufEUk4RYqF&ff=20210505215813&v=2.14.4" target="_blank" rel="noopener" class="underlink bluelink" tabindex="-1">33948682 | DOI:10.1007/s00405-021-06732-6

View on the web

Intraoperative near‐infrared autofluorescence imaging for hypocalcemia risk reduction after total thyroidectomy: Evidence from a meta‐analysis

xlomafota13 shared this article with you from Inoreader

Abstract

This meta‐analysis evaluates whether near‐infrared autofluorescence (NIRAF) imaging reduces the risk of hypocalcemia after total thyroidectomy. A systematic literature search in PubMed, EMBASE, Web of Science, and Cochrane Library for studies from June 2011 to January 2021 comparing total thyroidectomy with NIRAF and conventional surgery (naked eye). Six eligible studies involving 2180 patients were included. The prevalence of transient hypocalcemia was 8.11% (40/493) and 25.19% (425/1687) in the NIRAF and naked eye groups (p < 0.0001), respectively. The prevalence of permanent hypocalcemia was 0% (0/493) and 2.19% (37/1687) in the NIRAF and naked eye groups (p = 0.05), respectively. NIRAF reduces the risk of transient hypocalcemia and may possibly lower the rate of permanent hypocalcemia. Nonetheless, further studies are needed to verify our results and evaluate the cost‐effectiveness of NIRAF in real‐world clinical practice.

View on the web

Intact Parathyroid Hormone Levels in Predicting Postoperative Hypocalcaemia After Total Thyroidectomy in South Indian Population: Cross Sectional Study

xlomafota13 shared this article with you from Inoreader

12070.jpg

Abstract

Hypocalcaemia being one of the most common complications after total thyroidectomy may not be avoidable in all cases. This study evaluated the effectiveness of intact Parathyroid hormone (iPTH) measured at 1-h after total thyroidectomy in predicting postoperative hypocalcaemia in early postoperative period in South Indian population. Patients who underwent total thyroidectomy in our institute from 2016 to 2018 were included. Preoperative calcium and iPTH levels were measured. Patients' iPTH level was measured 1 h after surgery and serum calcium level was measured at 24 h after surgery. Patients were also monitored clinically for any symptoms and signs of hypocalcaemia. A total of 57 patients were studied. The malignant causes accounted for 75.4% with papillary carcinoma thyroid being the most common cause. 65.7% of patients who underwent total thyroidectomy and 100% of patients who underwent total thyroidectomy with neck dissection developed hypocalca emia. 70% of patients with low iPTH developed hypocalcaemia and none of the patients who had normal iPTH developed hypocalcaemia. This relation was statistically significant with p value of 0.018 (< 0.05). The positive predictive value is 70% and negative predictive value is 100%. Though our study supports the hypothesis that iPTH is effective in predicting hypocalcaemia after total thyroidectomy in the early postoperative period, a larger sample study is needed to further support this. It can be used to consider patients for early discharge or to prophylactically start oral calcium and Vitamin D supplementation based on iPTH levels at 1 h after surgery.

View on the web

Bacterial Biofilms on Tracheostomy Tubes

xlomafota13 shared this article with you from Inoreader

12070.jpg

Abstract

Tracheostomy is a commonly performed airway surgery for critically ill patients. Tracheostomy tube is an indwelling prosthesis, providing potential surface for growth of bacteria. Biofilm formation by bacteria as a self-protective mechanism, has led to worrisome antibacterial resistance and thus higher rate of nosocomial infections. A prospective observational study was conducted with a purpose of knowing most common organisms capable of forming biofilm on tracheostomy tube and their antibiotic sensitivity in our setting. Fifty seven percent of the isolates were found to be capable of biofilm production. Acinetobacter baumannii (45%) was the commonest biofilm producer isolated and the commonest multidrug resistant organism (35.7%), followed by Klebsiella pneumoniae (28.5%). Both biofilm producers and non-biofilm producers were found most susceptible to Amikacin (43%), followed by Gentamicin (30%) and Ciprofloxacin (18.5%). No significant associa tion was found between biofilms and ventilators (p value = 0.558) or pre-existing infection (p value = 0.66) using Chi square test. Potentially biofilm producing bacteria were isolated from tracheostomy tube inner surfaces just after a week of their insertion, in majority of patients. Acinetobacter baumannii and Klebsiella pneumoniae were the commonest biofilm forming organisms and Amikacin, Gentamicin and Ciprofloxacin were most sensitive drugs. Multi drug resistant organisms were also commonly found, stressing the need for sensitivity-based antibiotics. Ventilator usage had no strong association with biofilm formation. Patients with non-infectious conditions also harboured bacteria capable of biofilms in tracheostomy tubes demanding the need for stringent tube hygiene measures and prophylactic antibiotics.

View on the web

Primary Hydatid Cyst of Neck, A Rare Case Report

xlomafota13 shared this article with you from Inoreader

12070.jpg

Abstract

Hydatid cyst is a result of parasite infection. The neck is an uncommon site for this infection so it is not considered as a differential diagnosis of neck swelling commonly. We hereby report a case of 24 year female with left postero-lateral neck swelling for 5 years that was insidious in onset and gradually increased in size. We diagnosed the case as hydatid cyst of neck on FNAC and MRI. Pre operatively oral albendazole was given for 1 month and continued post operatively. Our case has not shown recurrence for 6 months after successful surgical excision. So primary hydatid cyst should be considered as a differential diagnosis of neck swelling and should be treated accordingly.

View on the web

Assessment of Quality of Life and Symptoms in Non Syndromic Paediatric Obstructive Sleep Apnoea Patients: Before and After Adenotonsillectomy

xlomafota13 shared this article with you from Inoreader

12070.jpg

Abstract

This study aims to assess the improvement in quality of life and symptoms in paediatric obstructive sleep apnoea patients before and after adenotonsillectomy. From all paediatric patients who presented to our OPD with complaints of mouth breathing and snoring, a subset of patients fulfilling our inclusion criteria were selected and evaluated with PSQSRBD scale, quality of life (QoL) inventory and PSG level-III. Later37 patients who had moderate to severe OSA were selected for study and underwent adenotonsillectomy. They were further followed up postoperatively at 3 months and 7 months with PSQSRBD Scale and QoL inventory. The study cohort had 37 patients with moderate to severe OSA, with a mean age of 8yrs.The postoperative (mean of 3rd and 7th month) values of PSQSRBD Scale and QoL inventory values was significantly (p < 0.001) reduced compared to preoperative Values after adenotonsillectomy. There is statistically significant correlati on between adenoid and tonsil size to the relief of symptoms (PSQSRBD SCALE values) and improvement of quality of life. In our study, surgical (adenotonsillectomy) intervention has significant effect in management of moderate to severe non syndromic paediatric OSA patients.

View on the web

Therapeutic effects of melatonin on an ovalbumin-induced allergic rhinitis

xlomafota13 shared this article with you from Inoreader

1-s2.0-S0385814621X00053-cov150h.gif

Publication date: Available online 5 May 2021

Source: Auris Nasus Larynx

Author(s): Asli Cakir Cetin, Mustafa Cenk Ecevit, Mukaddes Gumustekin, Cetin Pekcetin, Seda Ozbal, Hande Efe, Pelin Koca, Ozge Akcay, Yesim Tuncok

View on the web

Laryngeal lichen planus mimicking vocal fold dysplasia

xlomafota13 shared this article with you from Inoreader

1-s2.0-S0385814621X00053-cov150h.gif

Publication date: Available online 6 May 2021

Source: Auris Nasus Larynx

Author(s): Giuseppe Leoncini, Maria Grazia Marin, Carmine Squeglia, Silvia Elisabetta Aquilini, Livio Zanetti

View on the web

Integrating Robot‐Assisted Ultrasound Tracking and 3D Needle Shape Prediction for Real‐Time Tracking of the Needle Tip in Needle Steering Procedures

xlomafota13 shared this article with you from Inoreader

Abstract

Background

Needle insertions have been used in several minimally invasive procedures for diagnostic and therapeutic purposes. Real‐time position of the needle tip is an important information in needle steering systems.

Methods

This work introduces a robot‐assisted ultrasound tracking (R‐AUST) system integrated with a needle shape prediction method to provide 3D position of the needle tip. The tracking system is evaluated in phantom and ex‐vivo beef liver tissues.

Results

An average error of 0.60 mm was found for needle insertion tests inside the phantom tissue. The R‐AUST integrated with shape prediction in the beef liver tissue was able to track the needle tip with an average and maximum error of 0.37 and 0.67mm, respectively. The average error reported in this work is within the mean allowable needle placement error (<2.7mm) in targeted procedures.

Conclusions

Integration of R‐AUST tracking method with needle shape prediction results in a reasonably accurate real‐time tracking suitable for ultrasound‐guided needle insertions.

This article is protected by copyright. All rights reserved.

View on the web

Assessment of eye closure and blink with facial palsy: A systematic literature review

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Mar 30:S1748-6815(21)00149-2. doi: 10.1016/j.bjps.2021.03.059. Online ahead of print.

ABSTRACT

Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure in patients with decreased facial nerve function. There are no standardized measures of voluntary and spontaneous eye closure that are used to evaluate the outcomes of blink restoration procedures. The purpose of this systematic literature review was to identify the measures used to assess normal and abnormal eye closure and blinking in patients with facial palsy. A literature search of the PubMed database using the keyword "facial nerve/surgery" was conducted. Only English language articles that pertain to the use of facial paralysis assessment systems published in the past 20 years, which involve eyelid closure were included. There were 57 articles that used a facial paralysis classification system with an eyelid closure component: House-Brackmann Facial Nerve Grading Scale (n = 43, 67%); Sunnybrook Facial Grading Scale (n = 9); palpebral fissure heights (n = 4), and the electronic clinician-graded facial function tool (n = 3) and three additional measures were reported once. Although the Terzis and Bruno Scoring System, blink ratio, and electronic, clinician-graded facial function scale(eFACE) Clinician-Graded Scoring System were valid measures of eyelid closure, there was no one comprehensive eye assessment that demonstrated all aspects of eye closure in facial palsy, which include closure amplitude, spontaneity, and quality of life. For blink assessment, eFACE is the most comprehensive tool currently available and recommended to be used with a patient-reported quality of life supplement that captures the specific domains related to facial nerve dysfunction.

PMID:33952434 | DOI:10.1016/j.bjps.2021.03.059

View on the web

The combined use of pedicled profunda artery perforator and bilateral gracilis flaps for pelvic reconstruction: A cohort study

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Mar 30:S1748-6815(21)00128-5. doi: 10.1016/j.bjps.2021.03.038. Online ahead of print.

ABSTRACT

The result of an extra-levator abdominoperineal excision of the rectum (ELAPE) is a composite three-dimensional defect. This is performed for locally advanced anorectal cancer, and may involve partial excision of the vagina. The aim of reconstruction is to achieve wound healing, restore the pelvic floor and to allow micturition and sexual function. We aim to evaluate the concurrent use of profunda artery perforator (PAP) and bilateral gracilis flaps for vaginal and pelvic floor reconstruction. We performed a retrospective case note review of patients undergoing pelvo-perineal reconstruction with combined gracilis and PAP flaps between July 2018 and December 2019. Eighteen pedicled flaps were performed on six patients with anal or vulval malignancies. All underwent pre-operative radiotherapy. Four patients h ad extended abdominoperineal tumour resections, while two patients underwent total pelvic exenteration. The median age was 57 (range 47-74) years, inpatient stay was 22 (11-47) days and the follow-up was 10 (5-21) months. Four patients developed partial perineal wound dehiscence, of which one was re-sutured. One patient had a post-operative bleed requiring radiological embolisation of an internal iliac branch and had subsequent 1cm PAP flap loss. All other flaps survived completely. Median time to heal was 4 (1-6) months. This is the first series reporting combined bilateral gracilis and PAP flaps for pelvic reconstruction. The wound dehiscence rate and healing times were expected in the context of irradiation and radical pelvic tumour resection. This is a reliable technique for perineal and vaginal reconstruction with minimal donor site morbidity.

PMID:33952435 | DOI:10.1016/j.bjps.2021.03.038

View on the web

Computer-assisted mandibular curved osteotomy: An automatic method to design the new aesthetic gonion and osteotomy line

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Apr 6:S1748-6815(21)00157-1. doi: 10.1016/j.bjps.2021.03.067. Online ahead of print.

ABSTRACT

BACKGROUND: Digital technology has been widely used in mandibular curved osteotomy to improve accuracy. However, the planning process still highly dependent on the experience and judgement of the surgeon. This study describes an automatic method to design the new gonion and osteotomy line based on the aesthetic standards in attractive women, and assesses its clinical outcomes.

METHODS: An automatic surgical planning method for mandibular curved osteotomy was developed based on our previous research of mandibular angle aesthetics. A prospective clinical study was conducted from April 2016 to April 2018. Twenty-five female patients with prominent mandibular angle were enrolled. Pre- and postoperative skull computed tomography (CT) was performed. Three-dimensional (3D) CT data were obtained and processed by Mimics 18.0. Surgical templates were designed according to the automatic surgical planning method and 3D printed for the surgery. Preoperative measurements, surgical simulation and postoperative measurements were taken to evaluate the surgical outcomes.

RESULTS: There were significant differences between the preoperative and the postoperative groups' results (p < 0.01). There was no difference between the surgical simulation and the postoperative results. All postoperative measurements were consistent with aesthetic features of mandibles. Patients were satisfied with their outcomes in terms of outline, symmetry and lower facial width.

CONCLUSIONS: Our study developed an automatic method to position the new aesthetic gonion and osteotomy line for prominent mandibular angle patients. We proved that this method is safe, effective and reliable.

PMID:33952433 | DOI:10.1016/j.bjps.2021.03.067

View on the web