Surgical management of troublesome mastoid cavities

AbstractObjective:To examine the reasons for discharging mastoid cavities, the operative findings during revision surgery, and the medium-term outcome.Patients:One hundred and forty revision mastoidectomies in 131 patients were studied. Post-operatively, patients were followed up at three, six and 12 months and then yearly.Intervention:A variety of techniques were performed. Over 80 per cent of ears were treated with mastoid obliteration. Concomitant hearing restorative procedures were carried out in one-third of the ears.Results:The mastoid cavities were troublesome because of large cavity size, bony overhang, residual infected mastoid cells, the presence of cholesteatoma or perforations, and/or inadequate meatoplasty. One year after revision mastoidectomy, over 95 per cent of the ears had become completely ‘dry’ and water-resistant. Overall, 50.9 per cent of the ears had a 12-month post-operative air–bone gap of 20 dB or less.Conclusion:Revision mastoidectomy has a high success rate in converting troublesome mastoid cavities into dry, water-resistant ears.

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Transcatheter closure of perimembranous and muscular ventricular septal defects: short and medium-term outcome

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2020.62.1 ◽

2020 ◽

Author(s):

Anh Binh Ho

Keyword(s):

Success Rate ◽

Transcatheter Closure ◽

Central Hospital ◽

Ventricular Septal Defects ◽

Medium Term ◽

Term Outcome ◽

Surgical Closure ◽

Septal Defects ◽

First Choice

Transcatheter closure of perimembranous and muscular ventricular septal defects: short and medium-term outcome ABSTRACT Objective: This study attempted to report the initial results: the safety and efficacy of transcatheter closure of ventricular septal defects (VSDs) at Hue Central Hospital with the short and medium-term follow-up. Methods: From September 2012 to May 2017, a total of 36 patients with perimembranous or muscular VSD underwent an attempt of transcatheter closure at the Department of Interventional Cardiology, Hue Central Hospital. Results: 14 males and 26 females participated in this study, with the age of 17,29  13.72 and 24.23  12.32 respectively. Among these patients, 19.44% of them were under 6-year-old; 72.22% had perimembranous VSDs, 27.78% had muscular VSDs, and 33.33% had aneurysm. The distance to AV was 5.62 ± 4.32 mm. The device size was 15.31± 8.12 mm. Procedures lasted for 57.17 ± 26.5 min with 15.31± 8.12 min of exposure. The complete closure rates by transthoracic echocardiography after 24 hours, 1 month, 3 months and 6 months (transthoracic) were 94.44%; 94.44% ; 97.22% and 100%, respectively. Mean time of follow-up was 11.92 ± 8.36 (3-38) months. Success rate was 97.22% and no death occurred. There was 1 case of hematuria, lasting 1 month; no Atrioventricular (AV) block. Conclusions: Transcatheter closure of VSDs is a novel, feasible and safe technique with high success rate (97.22%). The transcather approach provides a less invasive alternative than surgical closure and might become the first choice treatment in selected patients. Key words: transcatheter closure, ventricular septal defects

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Medium Term Outcome of Lancaster Cortical Window Technique For Extraction of Femoral Stem in Revision Hip Arthroplasty

10.21203/rs.3.rs-149542/v1 ◽

2021 ◽

Author(s):

Amit Singh ◽

Sunirmal Mukherjee ◽

Kuntal Patel ◽

Deepak Herlekar ◽

Srikant Gandavaram ◽

...

Keyword(s):

Hip Arthroplasty ◽

Revision Surgery ◽

Femoral Stem ◽

Revision Hip Arthroplasty ◽

Medium Term ◽

Term Outcome ◽

Window Technique ◽

Femoral Stems ◽

The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster Cortical Window technique which can be used for removal of cemented or uncemented femoral stems. Methodology The study was conducted at a specialist centre in the North-West of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using Lancaster Cortical Window technique for removal of femoral implant during a revision hip arthroplasty. Patient’s electronic notes and the radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using Novel Lancaster Window technique. The mean age of the all the patients was 81.5 years and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular component. Rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow up. Conclusion We believe Lancaster cortical window technique can be safely used for removal of cemented stems during revision hip arthroplasty without the need for expensive equipment’s.

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Medium term outcome of Lancaster cortical window technique for extraction of femoral stem in revision hip arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02458-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Amit Singh ◽

Sunirmal Mukherjee ◽

Kuntal Patel ◽

Deepak Herlekar ◽

Srikant Gandavaram ◽

...

Keyword(s):

Hip Arthroplasty ◽

Revision Surgery ◽

Femoral Stem ◽

Revision Hip Arthroplasty ◽

Medium Term ◽

Term Outcome ◽

Window Technique ◽

Femoral Stems ◽

The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in the speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster cortical window technique which can be used for the removal of cemented or uncemented femoral stems. Methods The study was conducted at a specialist centre in the north-west of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using the Lancaster cortical window technique for removal of the femoral implant during a revision hip arthroplasty. Patient’s electronic notes and radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using the novel Lancaster window technique. The mean age of all the patients was 81.5 years, and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular components. The rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow-up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow-up. Conclusion We believe Lancaster cortical window technique can be safely used for the removal of cemented stems during revision hip arthroplasty without the need for expensive equipment.

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Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽

10.1024/0301-1526.31.1.36 ◽

2002 ◽

Vol 31 (1) ◽

pp. 36-42 ◽

Cited By ~ 3

Author(s):

. Bucek ◽

Hudak ◽

Schnürer ◽

Ahmadi ◽

Wolfram ◽

...

Keyword(s):

Success Rate ◽

Clinical Stage ◽

Ankle Brachial Index ◽

Clinical Situation ◽

Clinical Results ◽

Transluminal Angioplasty ◽

Term Outcome ◽

Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

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