scholarly journals Outcomes and CT scan three-dimensional volumetric analysis of emergent paraesophageal hernia repairs: predicting patients who will require emergent repair

Author(s):  
Sharbel A. Elhage ◽  
Angela M. Kao ◽  
Michael Katzen ◽  
Jenny M. Shao ◽  
Tanushree Prasad ◽  
...  
Author(s):  
Kyubeom Kim ◽  
Junhyung Kim ◽  
Insik Yun ◽  
Taehee Jo ◽  
Jaehoon Choi ◽  
...  

Objectives: In this study, we designed a new technique for open septal reduction using a polydioxanone (PDS) plate and compared it with closed reduction. Design, Setting, Participants: This study included nineteen consecutive patients with nasoseptal fracture: ten receiving open reduction with a PDS plate (PDS group) and nine undergoing closed reduction (CR group). Open septal reduction was performed after closed reduction for nasal bone fracture. A mucoperichondrial flap was unilaterally elevated, and the deviated septal cartilage was reduced. The PDS plate was inserted horizontally above the vomerine suture. Surgical outcome was analyzed with three-dimensional volumetry and with a quality-of-life scale for nasal obstruction (NOSE scale). Results: Complications included one case of septal perforation in the CR group and one case of PDS exposure and septal hematoma in the PDS group. In the 3D volumetric analysis of the PDS group, the median value of the nasal cavity change significantly differed between 1.14 mL (interquartile range; 0.46 to 2.4) at the preoperative CT scan and 0.33 mL (interquartile range; -0.22 to 1.29) at the postoperative CT scan (**p = 0.0039). The NOSE scale revealed significant improvement in nasal obstruction postsurgically (median value, 42.5 to 7.5; *p = 0.0139) in the PDS group. Conclusion: PDS plates potentially present a new concept of open septal reduction in terms of septal reinforcement compared with the subtractive approach of open septal reduction.


2004 ◽  
Vol 16 (3) ◽  
pp. 249-254 ◽  
Author(s):  
Francis D. Ferdinand ◽  
Mark Heiman ◽  
Sharon Ben-Or ◽  
Andrew J. Curtain ◽  
Scott M. Goldman

Radiology ◽  
1996 ◽  
Vol 200 (3) ◽  
pp. 843-850 ◽  
Author(s):  
K E Smith ◽  
P K Commean ◽  
M W Vannier

2006 ◽  
Vol 163 (7) ◽  
pp. 1252-1263 ◽  
Author(s):  
M. Mehmet Haznedar ◽  
Monte S. Buchsbaum ◽  
Erin A. Hazlett ◽  
Elizabeth M. LiCalzi ◽  
Charles Cartwright ◽  
...  

2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Robert D. Thomas ◽  
Scott M. Graham ◽  
Keith D. Carter ◽  
Jeffrey A. Nerad

Background Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. Methods A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. Results There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1–2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 ± 0.06 cm3 and a postoperative volume of 19.56 ± 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Conclusion Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients’ enophthalmos may improve with endoscopic antrostomy alone.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
TATSUYA ODA ◽  
Kenji Minatoya ◽  
Hiroaki Sasaki ◽  
Hiroshi Tanaka ◽  
Yoshimasa Seike ◽  
...  

Background: Because of a lack of information about the rupture size of chronic dissecting descending thoracic and thoracoabdominal aneurysms, we evaluated the natural history of those aneurysms. Patiens and Methods: Data on 422 patients (mean age, 63.3 ± 11.3; 272 male) with chronic dissection in descending thoracic and thoracoabdominal aorta treated at our institution from 2007 to 2014, were analyzed. Patients with connective tissue disorder, impending rupture of aneurysms, infected aneurysms, and an acute dissection without aneurysms were excluded. Chronic dissection was defined as a dissection more than 2 weeks from symptom onset. The aneurysm diameter at the time of the rupture was measured on CT scan in ruptured aneurysms group (n=21), and initial aneurysmal diameter on CT scan in non-ruptured aneurysms group (n=401). The measurements were performed at maximum short axis diameter of the aneurysm on three-dimensional CT. Results: Midian size of all aneurysms was 4.5 cm (range 3.5 to 9.0 cm) and that of in ruptured aneurysms was 5.9 cm (range 4.5-8.0 cm). The location of aneurysms was descending aorta in 303 patients, thoracoabdominal aorta in 119. Aortic surgery was performed in 150 patients (urgent in 20, elective in 130). Hospital mortality rate were 20% (5/20) in patients with ruptured aneurysms and 2.3% (3/130) in patients with non-ruptured aneurysms. Figure shows the incidences of rupture according to the aneurysm size. The incidence of a rupture increases with larger aortic size. At 3.5 to 3.9 cm, 4.0 to 4.4 cm, 4.5 to 4.9 cm, 5.0 to 5.4 cm, 5.5 to 5.9 cm and more than 6.0 cm, the incidence of rupture was 0%, 0%, 1.2%, 10.2%, 14.3% 20.8%, respectively. The aneurysms more than 5.0 cm were ruptured in 15.1% of patients. Conclusions: Because an elective operation is associated with low mortality, operative indication of chronic dissecting aneurysm in descending and thoracic-abdominal aorta should be considered when its size is 5.0 cm or larger in good-risk patients.


ESC CardioMed ◽  
2018 ◽  
pp. 88-92
Author(s):  
Luigi Badano ◽  
Denisa Muraru

The left and right atria are dynamic structures that play an integral role in cardiac performance by modulating the respective ventricular filling. This function is accomplished by their role as a reservoir for venous return during ventricular systole, a conduit for venous return during early ventricular diastole, and a booster pump for ventricular filling during late diastole. Recent advances in cardiac imaging allow the accurate assessment of the geometry and phasic functions of both atria. Two- and three-dimensional echocardiography enables a volumetric analysis of atrial function, and both Doppler tissue imaging and speckle-tracking echocardiography allow the assessment of the deformation of atrial myocardium.


2019 ◽  
Vol 43 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Hyeonjong Lee ◽  
Yong Kwon Chae ◽  
Hyo-Seol Lee ◽  
Sung Chul Choi ◽  
Ok Hyung Nam

Objectives: This study was designed to compare the surface morphologies and volumes of posterior prefabricated zirconia crowns and posterior stainless steel crowns (SSCs) using digitalized three-dimensional (3D) reconstructed images. Study design: We tested prefabricated zirconia crowns (NuSmile ZR; Orthodontic Technologies, Houston, TX, USA) and SSCs (Kids Crown; Shinhung, Seoul, Korea) used to restore left maxillary and mandibular molars. A Rainbow scanner (Dentium, Seoul, Korea) was used to digitise the inner and outer surface morphologies of all crowns. The data were superimposed and evaluated using 3D software. The differences between the outer and inner surfaces and inner volume were measured. Results: The differences between the two types of crowns differed by tooth surface. At the occlusal surface, the differences were greater at the cusp tip than the fossa. At the axial level, the differences decreased toward the gingival margins. Also, relative volumetric ratios varied. Conclusions: Tooth preparation prior to placement of prefabricated zirconia crowns requires special consideration. Greater amounts of tooth reduction are necessary for posterior zirconia crowns than for SSCs. The occlusal surface requires more tooth reduction than the axial surface and the gingival margin.


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