Donor site morbidities resulting from conchal cartilage harvesting in rhinoplasty

2017 ◽  
Vol 131 (6) ◽  
pp. 529-533 ◽  
Author(s):  
M Y Lan ◽  
J P Park ◽  
Y J Jang
Keyword(s):  
Complication Rate ◽  
Chart Review ◽  
Donor Site ◽  
Retrospective Chart Review ◽  
Donor Site Morbidity ◽  
Conchal Cartilage ◽  
Patient Demographics ◽  
Morbidity Data

AbstractObjective:Conchal cartilage is frequently used in rhinoplasty, but donor site morbidity data are seldom reported. This study aimed to investigate the complications of conchal cartilage harvesting in rhinoplasty.Methods:A retrospective chart review of 372 patients who underwent conchal cartilage harvesting for rhinoplasty was conducted. Data regarding patient demographics, types of nasal deformities, graft usage and complications were analysed.Results:A total of 372 patients who underwent conchal cartilage harvesting for rhinoplasty were enrolled. The harvested conchal cartilage tissues were used in a variety of applications: tip graft, dorsal graft, septal reinforcement and correction of nostril asymmetry. Nine cases (2.4 per cent) with donor site morbidities were identified, including four cases (1.1 per cent) with keloids and five cases (1.3 per cent) with haematomas.Conclusion:Conchal cartilage harvesting is a safe and useful technique for rhinoplasty, with a low complication rate. However, patients should be informed about the possibility of donor site morbidities such as keloids and haematomas.

scholarly journals Utility of Groin Flap in Penile Reconstruction

2020 ◽  
Vol 16 (3) ◽  
pp. 150-157
Author(s):  
Ji-An Choi ◽  
Jung-Ha Kwak ◽  
Kwang-Ryeol Lim ◽  
Chung-Min Yoon
Keyword(s):  
Chart Review ◽  
Donor Site ◽  
Retrospective Chart Review ◽  
Wound Dehiscence ◽  
Donor Site Morbidity ◽  
Postoperative Patient ◽  
Groin Flap ◽  
Volumetric Reconstruction ◽  
Tissue Defects

Background: Reconstruction surgery for skin and soft tissue defects of the penis would ideally secure sufficient volume, be safe in procedure, and involve a simple surgical technique. Among the wide variety of techniques that have been employed, the groin flap-based technique is considered a relatively simple option for volumetric reconstruction. In this retrospective study, the authors report cases of penile reconstructive surgery using a groin flap.Methods: We performed a retrospective chart review of patients with penile defects treated in our department. Reconstructive surgeries were carried out using pedicled groin flaps. Charts were reviewed to investigate duration of the surgeries, recovery and follow-up periods, and bulkiness at one and 10 months after surgery. Patients were observed postoperatively for complications, urination, and erectile function.Results: Six patients hospitalized from March 2009 to September 2013 for penile defects underwent surgery in our department. All patients recovered without any flap loss. The most common complication after surgery was wound dehiscence. Circumferences of penile shafts were measured at 1 and 10 months after surgery, and penile bulkiness at rest were found to be maintained at >86%. There were no patients with contracture, and in all patients, urination and erectile functions were satisfactory.Conclusion: Reconstructing penile defects using groin flaps was found to be favorable in terms of volumetric reconstruction and postoperative patient satisfaction. Furthermore, the surgery and recovery periods are short, and rates of complication and donor site morbidity are also low.

scholarly journals 763. 30 Day Readmission Outcomes in Patients Over 80 Years of Age Enrolled in an Outpatient Parenteral Antibiotic Therapy (OPAT) Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S339-S340
Author(s):  
Kathleen R Sheridan ◽  
Joshua Wingfield ◽  
Lauren McKibben ◽  
Natalie Clouse
Keyword(s):  
Readmission Rate ◽  
Chart Review ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Model Of Care ◽  
Readmission Rates ◽  
Parenteral Antibiotic ◽  
Patient Demographics

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.

Cochlear Implantation in the Elderly: Results and Quality-of-Life Assessment

2002 ◽  
Vol 111 (10) ◽  
pp. 890-895 ◽  
Author(s):  
Hamid R. Djalilian ◽  
Sharon L. Smith ◽  
Timothy A. King ◽  
Samuel C. Levine
Keyword(s):  
Quality Of Life ◽  
Complication Rate ◽  
Cochlear Implantation ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Life Assessment ◽  
Test Results

To assess the efficacy, quality of life, and complication rate of cochlear implantation in patients over 60 years of age, we performed a retrospective chart review of 31 cochlear implant patients more than 60 years old at the time of surgery (mean, 70 years; range, 62 to 86 years). All patients had improvement in their audiological test results after operation. Twenty-eight patients (93%) are regular implant users at a median follow-up of 12 months. Major complications occurred in 2 patients (6%). We conclude that cochlear implantation in the elderly population has excellent results, with a complication rate similar to that in patients less than 60 years old, and yields an improved quality of life.

Surgical treatment for intramedullary spinal cord melanocytomas

2008 ◽  
Vol 9 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Eric M. Horn ◽  
Peter Nakaji ◽  
Stephen W. Coons ◽  
Curtis A. Dickman
Keyword(s):  
Spinal Cord ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Complete Resection ◽  
Intramedullary Spinal Cord ◽  
Local Infiltration ◽  
Patients Âgés ◽  
Patient Demographics

Spinal meningeal melanocytomas are rare lesions that are histologically benign and can behave aggressively, with local infiltration. The authors present their experience with intramedullary spinal cord melanocytomas consisting of 3 cases, which represents the second largest series in the literature. A retrospective chart review was performed following identification of all spinal melanocytomas treated at the author's institution, based on information obtained from a neuropathology database. The charts were reviewed for patient demographics, surgical procedure, clinical outcome, and long-term tumor progression. Three patients were identified in whom spinal melanocytoma had been diagnosed between 1989 and 2006. The patients' ages were 37, 37, and 48 years, and the location of their tumor was C1–3, T9–10, and T-12, respectively. All 3 had complete resection with no adjuvant radiotherapy during follow-up periods of 16, 38, and 185 months, respectively. One patient demonstrated a recurrence 29 months after resection and the other 2 patients have demonstrated asymptomatic recurrences on imaging studies obtained at 16 and 38 months following resection. With these cases added to the available literature, the evidence strongly suggests that complete resection is the treatment of choice for spinal melanocytomas. Even with complete resection, recurrences are common and close follow-up is needed for the long term in these patients. Radiation therapy should be reserved for those cases in which complete resection is not possible or in which there is recurrence.

Donor Site Morbidity Post-Conchal Cartilage Grafting

1997 ◽  
Vol 21 (2) ◽  
pp. 90-92 ◽  
Author(s):  
A.O. Grobbelaar ◽  
B.A. Matti ◽  
F.V. Nicolle
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Conchal Cartilage ◽  
Cartilage Grafting

scholarly journals Influence of Endothelin-1 in Aqueous Humor on Intermediate-Term Trabeculectomy Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Lars Choritz ◽  
Benjamin Mahmoodi ◽  
Hagen Thieme
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Aqueous Humor ◽  
Complication Rate ◽  
Surgical Outcome ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Glaucoma Medication ◽  
Surgical Success ◽  
Endothelin 1

Purpose. To investigate whether increased concentrations of ET-1 in aqueous humor of glaucoma patients influences surgical outcome of standard trabeculectomy with Mitomycin C.Methods. Retrospective chart review of 36 glaucoma patients with known ET-1 concentrations who had undergone trabeculectomy with Mitomycin C. Patients were divided into two groups based on their aqueous ET-1 concentration, a below-median (low ET-1) and an above-median (high ET-1) group. Postoperative IOP development, necessity of glaucoma medication, surgical success and complications, postoperative use of antifibrotics (5-FU), and number of additional glaucoma surgeries were compared between the groups.Results. Overall surgical success of trabeculectomy was comparable to published literature (90%, 81%, 76%, and 68% absolute success at 12, 24, 36, and 48 months after surgery). There was no difference between high and low ET-1 group in the postsurgical development of IOP, surgical success rate, or complication rate. There was no difference in postoperative scarring or indirect indicators thereof (e.g., number of 5-FU injections, needlings, suture lyses, or IOP lowering medications).Conclusion. In this set of patients, ET-1 in aqueous humor does not appear to have influenced surgical outcome of trabeculectomy with Mitomycin C. There is no indication of an increased likelihood of bleb fibrosis in patients with increased ET-1 concentrations.

Retrospective chart review of minor tibial fractures in preschoolers: immobilisation and complications

2020 ◽  
Vol 37 (6) ◽  
pp. 345-350
Author(s):  
Charlotte A Ferrier ◽  
Rachel Schembri ◽  
Sandy M Hopper
Keyword(s):  
Complication Rate ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Tibial Fractures ◽  
Treatment Practices ◽  
Bony Injury ◽  
Salter Harris ◽  
To Receive ◽  
Active Care

ObjectiveTo compare the treatment practices (immobilisation vs non-immobilisation) of toddler fractures and other minor tibial fractures (both proven and suspected) in preschoolers, aged 9 months–4 years, and examine rates of ED re-presentations and complications.MethodsRetrospective chart review of presentations of minor tibial fractures, both proven (radiologically confirmed) or suspected (negative X-ray but clinical evidence of bony injury), in children aged 9 months–4 years presenting to a single tertiary level paediatric ED from May 2016 to April 2018. Data collected included treatment practices, subsequent unscheduled re-presentations (including reasons) and complications (defined as problems relating to the injury that required further active care).ResultsA search of medical records yielded 240 cases: 102 had proven fractures (spiral, buckle or Salter-Harris II) and 138 were diagnosed with a suspected fracture. 73.5% of proven fractures were immobilised, predominantly with backslabs. 79% of suspected fractures were treated with expectant observation without immobilisation. Patients treated with immobilisation were more likely to re-present to ED compared with non-immobilised patients (18/104, 17.3% vs 9/136, 6.6% RR 2.62, 95% CI 1.23 to 5.58). 21 complications were seen in 19/104 (18.3%) immobilised patients. There were eight skin complications (complication rate of 7.7%) and 11 cast issues (complication rate of 10.6%). Two (1.5%) of the 136 patients had complications related to pain or limp. Pain was uncommonly found, although follow-up was not universal.ConclusionIn our centre, proven minor tibial fractures were more likely to receive a backslab, whereas for suspected fractures, expectant observation without immobilisation was performed. Although there is potential bias in the identification of complications with immobilisation, the study suggests that non-immobilisation approach should be investigated.

Factors Associated With Patient Nonattendance in Rhinology Clinics

2019 ◽  
Vol 33 (3) ◽  
pp. 317-322
Author(s):  
Benjamin N. Hunter ◽  
Brandon Cardon ◽  
Gretchen M. Oakley ◽  
Arun Sharma ◽  
Dana L. Crosby
Keyword(s):  
Chart Review ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Patient Demographics ◽  
Medical Centers ◽  
Insurance Type ◽  
Academic Medical ◽  
Included Patient

Background Nonattendance to clinical appointments is a global problem appreciated by clinicians with an ambulatory presence. There are few reports of nonattendance in otolaryngology clinics, and no reports on nonattendance for a single otolaryngology subspecialty. Objective To describe the no-show population in rhinology clinics. Methods A retrospective chart review was performed involving rhinology clinics from 2 academic medical centers in the United States. All patients who either attended their clinic appointment(s) or did not attend without previously cancelling from June 2016 to May 2017 were included. Data collected included patient demographics, appointment status, season and time of visit, insurance status, type of visit (new vs established), and provider seen. Results There were 2791 clinical appointments evaluated over a 12-month period at 2 rhinology clinics involving 4 fellowship-trained rhinologists. Ninety-two percent of patients kept their appointments, while 8% did not. Sex, season of visit, time of visit (am vs pm), type of visit, provider sex, provider location, or provider’s experience (<10 years vs ≥10 years) were not associated with patient’s attendance status. Univariate analysis showed that patient’s age ≤50 ( P = .001) and primary insurance type ( P < .001) were associated with nonattendance. Medicaid as the primary insurance type was associated with clinic nonattendance. Multivariable analysis showed that age ≤ 50 years, odds ratio (OR) 1.62 (95% confidence interval [CI] 1.14–2.30), P = .007, and primary insurance type (Medicaid: OR 3.75 [95% CI 2.58–5.45], P < .001) remained significant predictors of nonattendance. Conclusion Patients younger than 50 years and patients with Medicaid as the primary insurance types are associated with risk of missing rhinology clinic appointments. As a subspecialty, delivery of timely care and clinical efficiency could be improved by interventions directed toward improving attendance among this population.

Hemoglobin Levels and Serum C-Reactive Protein in Patients With Moderate to Severe Hidradenitis Suppurativa

2019 ◽  
Vol 23 (5) ◽  
pp. 501-506 ◽  
Author(s):  
Christina M. Huang ◽  
Michelle A. Lowes ◽  
Christine Cserti ◽  
Afsaneh Alavi
Keyword(s):  
Disease Severity ◽  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Inflammatory Diseases ◽  
Retrospective Chart Review ◽  
C Reactive Protein ◽  
Patient Demographics ◽  
Reactive Protein ◽  
Anemia Of Chronic Inflammation ◽  
One Way Anova

Introduction: Anemia of chronic inflammation is associated with many inflammatory diseases. Little is known about anemia in hidradenitis suppurativa (HS). This study aimed to review the levels of hemoglobin (Hb) and investigate its relationship with serum C-reactive protein (CRP) and disease severity in HS patients. Methods: This was a retrospective chart review of all HS patients from 2015 to 2017 with Hb and CRP blood work. Patient demographics, disease severity, and laboratory results were extracted. Data were analyzed descriptively. A linear regression model was used for the association between Hb and CRP. Two-tailed t-tests and one-way ANOVA were used to compare differences between sexes and disease severities. Results: Of the 25 patients included, 14 (56%) were female. The median age and disease duration of all patients were 41 years (range, 19-56 years) and 10 years (range, 1-40 years), respectively. The overall median CRP level was 11.5 mg/dL (range, 1-86.7 mg/dL). The median Hb levels for women and men were and 123.5 g/L (range, 90-142 g/L) and 152.0 g/L (range, 109-166 g/L), respectively. Anemia was found in 42.9% (6/14) of women and 27.3% (3/11) of men. There was an inverse relationship between Hb and CRP levels in both sexes (men: r = ‒0.88; P = .0006; women r = ‒0.65; P = .012). Conclusions: Anemia was prevalent in the HS population, and Hb levels inversely correlated with CRP. Physicians should be aware that anemia is common in inflammatory states, and that CRP could be a biomarker in patients with HS.

The effect of polysomnography on pediatric adenotonsillectomy postoperative management

2005 ◽  
Vol 132 (2) ◽  
pp. 263-270 ◽  
Author(s):  
Anthony A. Rieder ◽  
Valerie Flanary
Keyword(s):  
Length Of Stay ◽  
Airway Obstruction ◽  
Complication Rate ◽  
Chart Review ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Postoperative Management ◽  
Postoperative Course

OBJECTIVE: We retrospectively investigated the effect and predictability of preoperative polysomnography (PSG) on the postoperative course of younger pediatric patients undergoing adenotonsillectomy. STUDY DESIGN AND SETTING: A retrospective chart review was performed for patients 3 years of age and younger who had undergone adenotonsillectomy between July 1997 and July 2002 at the Children's Hospital of Wisconsin. RESULTS: Two hundred eighty-two patients were identified. Forty-three patients had preoperative PSG. No correlation between the severity of PSG results and postoperative course was identified. CONCLUSIONS: The role of PSG in upper airway obstruction and OSA remains controversial. This study suggests that although the complication rate may be higher in this younger population, these complications do not appear to have a large impact on their length of stay. SIGNIFICANCE: This study suggests that the 3-years-and-younger group, in the absence of other comorbidities, can safely undergo adenotonsillectomy without undergoing preoperative PSG. EBM raing: C.

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