One-stage revision surgery for pediatric cholesteatoma: long-term results and comparison with primary surgery

Introduction: The management of periprosthetic joint infection (PJI) of the hip is a challenging procedure. One-stage exchange is carried out in specialist centres with comparable infection free survival rates. However, there is a paucity of long-term results of this approach in young patients. Methods: All patients undergoing one-stage exchange due to PJI with a known causative organism ⩽45 years of age with a minimum of 10-year follow-up (mean 15 years; range 10–24 years) were enrolled in this retrospective study. Patients older than 45 years of age or patients with a two-stage procedure were excluded from the study. The primary outcome measure was failure rate with special focus on reinfection at latest follow-up. Failure was defined as revision surgery for infection. Furthermore, functional outcome using the Harris Hip Score was determined initially and at latest follow-up. 26 patients fulfilled the inclusion criteria and were available for final follow-up. Results: The study cohort consists of 16 male and 10 female patients with a mean age of 36.8 years (range 20–45 years) and a mean BMI of 29.8 kg/m2 (range 20.7–40.6 kg/m2). Prior to the single-stage procedure, the patients underwent an average of 3.1 previous surgical interventions (range 1–9). The mean hospital stay after septic revision was 19.7 days (11–33 days). Most infections were caused by Staphylococcus epidermidis ( n = 8, 30.8%), followed by Staph. aureus ( n = 7, 26.9%) and Propionibacterium acnes ( n = 6, 23.1%). At latest follow-up, the overall survival rate was 76.9 %, while infection control could be achieved in 96.2%. At final examination, the mean Harris Hip Score improved from 46.2 to 78.9 (range 18.0–99; SD, 22.6). Conclusions: Single-stage revision surgery for the management of PJI in patients ⩽45 years is a successful treatment option with high infection control, even after long-term follow-up.

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Long-Term Results for a One-Stage Surgery Technique for Patients With Craniofacial Plexiform Neurofibroma

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000004685 ◽

2018 ◽

Vol 29 (8) ◽

pp. e746-e750 ◽

Cited By ~ 1

Author(s):

Liangbo Chen ◽

Chengrui Guo ◽

Xuefei Song ◽

Chenxi Yan ◽

Xiaojie Hu

Keyword(s):

Plexiform Neurofibroma ◽

Long Term Results ◽

One Stage ◽

Surgery Technique

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Cricohyoepiglottopexy: long-term results in 55 patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215100144421 ◽

1999 ◽

Vol 113 (6) ◽

pp. 532-537 ◽

Cited By ~ 17

Author(s):

J. G. Lallemant ◽

P. Bonnin ◽

I. El-Sioufi ◽

J. Bousquet

Keyword(s):

Total Laryngectomy ◽

Functional Result ◽

Anterior Commissure ◽

Long Term Results ◽

Tumour Control ◽

Primary Surgery ◽

Significant Difference ◽

Voice Preservation ◽

Discharge From Hospital

AbstractNear total laryngectomy with cricohyoepiglottopexy (CHEP) allows cure of glottic carcinomas with voice preservation. The subject of this study was to evaluate CHEP in terms of tumour control and functional result in T1 and T2 glottic carcinomas.This study reviewed retrospectively 55 consecutive cases of CHEP performed between January 1, 1981 and September 1, 1992 with the exclusion of post-radiotherapy salvage surgery. CHEP was indicated for a T1a limit to the anterior commissure and/or with dysplasia of the other vocal fold (10 cases), T1b (11 cases) and T2 (34 cases) glottic carcinomas. All our patients have a follow-up of more than five years.The post-operative course after this surgery was generally uneventful. The median time to decannulation was 18 days, to removal of the nasogastric tube was 15 days and to discharge from hospital was 23 days. No significant difference was observed according to the preservation of one or both arytenoid cartilages. The long-term functional result can be considered to be good in three-quarters of cases, with normal oral swallowing and an easily understood voice. The remaining one quarter had a whispery voice and sometimes episodes of aspiration when swallowing liquids. In terms of oncological results, the five-year recurrence-free survival rate was 94 per cent for T1 and 84 per cent for T2. The ultimate tumour control (taking into account four cases of total laryngectomy) was 94 per cent for T1 and 93 per cent for T2.Primary surgery by CHEP therefore appears to be a good option for early glottic carcinomas. The main problem remains that voice recovery is mediocre in one quarter of patients.

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Long-Term Results of a One-Stage Secondary Debulking Procedure after Flap Reconstruction of the Foot

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000002510 ◽

2016 ◽

Vol 138 (4) ◽

pp. 923-930 ◽

Cited By ~ 5

Author(s):

Tsan-Shiun Lin ◽

Richard Quing

Keyword(s):

Long Term Results ◽

Flap Reconstruction ◽

One Stage

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Early maxillary orthopaedics as a supplement to conventional primary surgery in complete cleft lip and palate cases — long-term results

Journal of Maxillofacial Surgery ◽

10.1016/s0301-0503(82)80034-9 ◽

1982 ◽

Vol 10 ◽

pp. 165-172 ◽

Cited By ~ 20

Author(s):

Wanda M. Gnoinski

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Long Term Results ◽

Primary Surgery

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Long-term follow-up of patients undergoing the modified Dunn procedure for slipped capital femoral epiphysis

Bone & Joint Open ◽

10.1302/2046-3758.14.bjo-2020-0010.r1 ◽

2020 ◽

Vol 1 (4) ◽

pp. 80-87

Author(s):

Caroline Passaplan ◽

Lucienne Gautier ◽

Emanuel Gautier

Keyword(s):

Avascular Necrosis ◽

Femoroacetabular Impingement ◽

Revision Surgery ◽

Slipped Capital Femoral Epiphysis ◽

Implant Removal ◽

Long Term Results ◽

Harris Hip Score ◽

Ucla Activity Score

Aims Our retrospective analysis reports the outcome of patients operated for slipped capital femoral epiphysis using the modified Dunn procedure. Results, complications, and the need for revision surgery are compared with the recent literature. Methods We retrospectively evaluated 17 patients (18 hips) who underwent the modified Dunn procedure for the treatment of slipped capital femoral epiphysis. Outcome measurement included standardized scores. Clinical assessment included ambulation, leg length discrepancy, and hip mobility. Radiographically, the quality of epiphyseal reduction was evaluated using the Southwick and Alpha-angles. Avascular necrosis, heterotopic ossifications, and osteoarthritis were documented at follow-up. Results At a mean follow-up of more than nine years, the mean modified Harris Hip score was 88.7 points, the Hip Disability and Osteoarthritis Outcome Score (HOOS) 87.4 , the Merle d’Aubigné Score 16.5 points, and the UCLA Activity Score 8.4. One patient developed a partial avascular necrosis of the femoral head, and one patient already had an avascular necrosis at the time of delayed diagnosis. Two hips developed osteoarthritic signs at 14 and 16 years after the index operation. Six patients needed a total of nine revision surgeries. One operation was needed for postoperative hip subluxation, one for secondary displacement and implant failure, two for late femoroacetabular impingement, one for femoroacetabular impingement of the opposite hip, and four for implant removal. Conclusion Our series shows good results and is comparable to previous published studies. The modified Dunn procedure allows the anatomic repositioning of the slipped epiphysis. Long-term results with subjective and objective hip function are superior, avascular necrosis and development of osteoarthritis inferior to other reported treatment modalities. Nevertheless, the procedure is technically demanding and revision surgery for secondary femoroacetabular impingement and implant removal are frequent. Cite this article: 2020;1-4:80–87.

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Reinforcement Rings for Deficient Acetabular Bone in Revision Surgery: Long-Term Results

Hip International ◽

10.1177/112070009700700206 ◽

1997 ◽

Vol 7 (2) ◽

pp. 57-64 ◽

Cited By ~ 6

Author(s):

E. Garcia-Cimbrelo ◽

J. Alonso-Biarge ◽

J. Cordero-Ampuero

Keyword(s):

Revision Surgery ◽

Clinical Results ◽

Long Term Results ◽

Cumulative Probability ◽

Metal Ring ◽

Kaplan Meier ◽

Medial Migration ◽

Cemented Cup

This study analyzes the long-term results of 23 metal ring supports used in revision surgery since 1979. Only a metallic ring and a cemented cup were used in this series. Bone grafts and cementless cups were excluded from this study. One deep infection was excluded from the follow-up study. In the 22 cases analyzed, the mean follow-up period was 10 years for all cases and 12.2 years for unrevised cases. Bone defects according to the AAOS classification were: Grade 1, 1 case, Grade 2, 1 case, Grade 3, 10 cases, and Grade 4, 10 cases. A Müller ring was indicated in an anterior or medial wall defect (12 cases) and a Burch-Schneider ring was indicated in an anterior or posterior column defect or in pelvic discontinuity (10 cases). The clinical results were good in 8 cases, fair in 8 cases, and poor in 6 cases. Six cases were rerevised or removed, resulting in a total cumulative probability of rerevison or removal of 23.8% after 10 years according to the Kaplan-Meier analysis. Postoperatively, 18 cases had neutral rings, 2 cases had horizontal rings, and 2 cases had vertical rings. Radiological cup migration was found in 12 cases, resulting in a total cumulative probability of migration of 56.8% after 13 years according to the Kaplan-Meier analysis. Changes in the acetabular angle were present in 2 cases, vertical migration in 12 cases, and medial migration in 10 cases. Our data suggest that the metal ring and cemented cup alone could be used for salvage surgery in elderly patients and in low-demand patients. Possibly, adding bone graft could improve these results.

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