The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not

AbstractObjectiveThe aim of this study was to compare the differences between the no tympanomeatal flap approach and the tympanomeatal flap approach in endoscopic myringoplasty.MethodA total of 132 patients with tympanic membrane perforation were randomly divided into two groups: the no tympanomeatal flap approach group (group A, 56 ears) and the tympanomeatal flap approach group (group B, 76 ears). A comparison between the two groups was made.ResultsThe average operation time of group A was 36.00 ± 5.24 minutes, which was significantly shorter than that of group B, which was 43.89 ± 4.57 minutes (p = 0.002). The blood loss of group A was 5.08 ± 1.83 ml, which was significantly less than that of group B (9.67 ± 2.29 ml; p < 0.001). There were no differences in the degree of hearing improvement, the rate of hearing improvement, the dry ear time (when the external auditory canal and the operating cavity were dry) after operation and the success rate of tympanic membrane repair when compared between the two groups.ConclusionCompared with group B, group A (no tympanomeatal flap approach) can achieve the same effect but has the advantages of a shorter operation time and less blood loss during the operation.

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Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

10.21203/rs.2.13914/v1 ◽

2019 ◽

Author(s):

Yanping Zeng ◽

Peng Cheng ◽

Jiulin Tan ◽

Zhilin Li ◽

Yuan Chen ◽

...

Keyword(s):

Blood Loss ◽

Posterior Approach ◽

Spinal Tuberculosis ◽

Surgical Techniques ◽

Operation Time ◽

Thoracolumbar Junction ◽

Group A ◽

The Mean ◽

Group B ◽

Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

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EFFICACY OF PERMEATAL ENDOSCOPIC MYRINGOPLASTY IN INACTIVE (MUCOSAL) CHRONIC OTITIS MEDIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.7915 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S552-55

Author(s):

Saleem Asif Niazi ◽

Shahzad Maqbool ◽

Yousra Riaz ◽

Zafarullah Khan ◽

Shafaq Zaman ◽

...

Keyword(s):

Tympanic Membrane ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Military Hospital ◽

Graft Take ◽

Group A ◽

Endoscopic Myringoplasty ◽

Group B

Objective: To determine the efficacy of permeatal ednoscopic myringoplasty, in inactive (mucosal) COM regarding, graft take and hearing improvement. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: This was conducted on a sample size of n=100. Patients having inactive (mucosal) COM with dry central small, medium and large perforations were included. Patients were divided in to three groups on the basis of age, group A 15-30 years, group B 31-45 years and group C 46-60 years. All the patients underwent per-meatal endoscopic myringoplasty, without raising the tympano-meatal flap, under general anesthesia. Patients were followed up over a period of six months. Graft take was assessed by microscopy. Hearing was assessed by Pure Tone Audiometry (PTA) with improvement in air bone gap to 15db as primary end point. Data was collected on structured performa. Data was analyzed using SPSS version 17. Results: In this study, 33 (33%) were males and 67 (67%) were females. Age ranged 15-60 years. Out of 5 patients lost to follow up. A total of 95 completed their follow up. Based on age of the patients, in group A, successful graft take was 100%. In group B, it was 91% & in group C it dropped to 46%. On the basis of tympanic membrane perforation size, the graft success rate in small perforations was 94.8%; in medium sized perforations it was 86.8% and in large sized perforations of tympanic membrane it was........

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Study on impact of duration of tympanic membrane perforation on hearing loss and audiological outcome after surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213280 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1462

Author(s):

Raies Ahmad ◽

Gopika Kalsotra ◽

Kamal Kishore ◽

Aditiya Saraf ◽

Parmod Kalsotra

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Pure Tone ◽

Tympanic Membrane Perforation ◽

Medical College ◽

Time Period ◽

Membrane Perforation ◽

Group A ◽

Duration Of Disease ◽

Group B

Background: The aim of the study was to assess impact of duration of tympanic membrane perforation on hearing loss and postoperative audiological outcome using pure tone audiogram.Methods: The present study was conducted on 100 patients in department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15 to 60 years who presented with tympanic membrane (pars tensa) perforation were included in the study. Results: In our study, mean preoperative hearing loss (AC threshold) of group A was 36.23±1.07 dB and of group B was 25.67±6.38 dB. Group C had mean preoperative hearing loss (AC threshold) of 28.78±6.50 dB. Mean preoperative air-bone gap (AB gap) of group A was 12.9±8.05dB and of group B was 13.86±4.19 dB. Group C had mean preoperative air-bone gap (AB gap) of 16.47±5.51 dB. Postoperatively, pure tone threshold at three months was least in group B (15.09±5.80 dB), followed by group C (15.68±4.66 dB) and group A (19.33±2.81 dB). Whereas, postoperative AB gap at 3 months was least in group C (10±3 dB), followed by group C (8.44±3.59 dB). Group B had maximum postoperative AB gap of 8.49±4.34 dB.Conclusions: This study did not show any correlation between duration of disease and degree of hearing loss.

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Clinical study on the tunnel approach in laparoscopic radical right hemicolectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16135 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16135-e16135

Author(s):

Xijie Zhang ◽

Junli Zhang ◽

Yuzhou Zhao

Keyword(s):

Colon Cancer ◽

Operation Time ◽

Right Hemicolectomy ◽

Lateral Approach ◽

Radical Right ◽

Lymph Node Yield ◽

Group A ◽

Laparoscopic Right Hemicolectomy ◽

Group B ◽

Approach Group

e16135 Background: The medial to lateral approach Laparoscopic right hemicolectomy complies with the “no-touch” principle, but need a demanding procedure with a steep learning curve. This study was designed to assess the superiority of the tunnel approach compared to traditional medial-to-lateral approach in laparoscopic right hemicolectomy for patients with right-sided colon cancer. Methods: The new method was called Tunnel Approach: The tunnel was formed with Toldt's gap was dissociated upward from the attachment of ileocecal part and retroperitoneum, then the right mesocolon was lifted to expose and divide the superior mesenteric blood vessel. We analyzed retrospectively the patients with resectable right-sided colon cancer confirmed by colonoscope and imaging who received the laparoscopic radical right hemicolectomy. The patients were divided into the tunnel approach (group A) and the traditional medial-to-lateral approach (group B) according to the surgical maneuver performed. Results: A total of 84 patients who received laparoscopic radical right hemicolectomy were assigned to group A (n = 42) or group B (n = 42) between January 2016 to June 2017. There was no difference in baseline characteristics including demographics, body mass index (BMI), tumor stage, tumor location and differentiation. The operation time and intraoperative blood loss in group A were significantly better than group B (137.74±22.7 vs. 153.1±28.8min, p < 0.05; 49.0±40.7 vs. 142.9±87.4ml, p < 0.05, respectively).There was no difference in tumor size(5.7±2.1 vs. 5.7±2.1cm, p>0.05), conversion to laparotomy rate(0 vs. 3, p>0.05), lymph node yield(30.5±14.4 vs. 27.9±12.7, p>0.05), time to first flatus(3.4±1.3 vs. 4.0±1.3d, p>0.05), postoperative hospital stays(10.0±2.2 vs. 12.3±3.0d, p>0.05) and complications(2 vs. 3, p>0.05) between two groups. There was no treatment-related death in both groups. Conclusions: The characteristic of “tunnel” approach is to convert the anatomy from a two-dimensional to a three-dimensional view, it showed the benefits of both speed and safety with low intraoperative conversion to laparotomy rate and mortality. This new tunnel approach right hemicolectomy is worth recommended.

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Paper patching in traumatic perforation of tympanic membrane

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185118 ◽

2018 ◽

Vol 5 (1) ◽

pp. 10

Author(s):

Vinod Shinde ◽

Sudeep Choudhary ◽

Mayur Ingale ◽

Paresh Chavan

Keyword(s):

Tympanic Membrane ◽

Standard Treatment ◽

Tympanic Membrane Perforation ◽

Spontaneous Healing ◽

Medical College ◽

Membrane Perforation ◽

Group A ◽

Inflammatory Drugs ◽

Group B ◽

Random Groups

Background: Traumatic perforations are not new for ENT surgeons. The dictum for treatment is to keep the ear dry and leave the tympanic membrane to heal by itself. Most of the time it heals completely, but if it does not, a tympanoplasty is required.Methods: 144 patients of traumatic tympanic membrane perforation, who reported in the outdoor patient department of Otorhinolaryngology, at Dr. D. Y. Patil Medical college, DPU, Pune, were divided in two random groups; Group A was treated with standard treatment while Group B was treated with patching of perforation as an adjuvant to standard treatment. A simple paper, (from the envelop of gel foam) was used for this procedure. The standard taught and performed treatment for a tympanic membrane perforation is administering antibiotics, antihistaminic and anti-inflammatory drugs and keeping the ear dry; leaving the perforation for spontaneous healing. Results: Group A 75% perforations had healed while in Group B 97.22% perforations healed completely.Conclusions: Paper patching supports the healing tympanic membrane and significantly improves the chances of spontaneous healing thus reducing the requirement of surgical intervention.

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TONSILLECTOMY IN PAEDIATRIC POPULATION

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.04.1540 ◽

2016 ◽

Vol 23 (04) ◽

pp. 499-503

Author(s):

Raheel Ahmad ◽

Farhan Salam ◽

Abdul Saeed Khan ◽

Faisal Bashir ◽

Atif Rafique

Keyword(s):

Standard Deviation ◽

Blood Loss ◽

Operative Time ◽

Controlled Trial ◽

Operation Time ◽

Group A ◽

Group B ◽

Cold Steel Dissection ◽

Cold Dissection ◽

Dissection Method

Objectives: To compare mean operative time and Intra operative blood lossbetween bipolar electro dissection and cold dissection tonsillectomy in paediatric population.Study Design: Randomized controlled trial. Place and Duration: Department of ENT and Headand Neck Surgery, Continental Medical College, Hospital Lahore, from 1 January 2015 to 30September 2015. Materials and Methods: This study included 164 patients of age group 4 to12 years of either gender undergoing tonsillectomy. The patients were divided into two equalgroups designated as A and B each having 82 patients using simple random sampling. Patientsin group A were operated for tonsillectomy by bipolar electrocautry while group B underwenttonsillectomy by cold steel dissection method. All patients in both groups were assessed foroperating time and intra-operative blood loss. Results: Out of 82 cases of Bipolar DissectionGroup 49(60%) patients were male and 33(40%) patients were female. Whereas in 82 casesof Cold Dissection Group 51(62%) patients were male and 31(38%) patients were female.Mean age of patients was 7.2(SD ± 1.97) years. Mean operation time was 15 minutes withstandard deviation ± 1.21 in group A as compared to group B where mean operation time was20 minutes with standard deviation ± 1.87. Mean blood loss was 7 ml with standard deviation± 2.53 in patients of group A as compared to Patients in group B who mean blood loss of 30ml with standard deviation ± 3.46. Group A had statistically significant lower operative time andblood loss than group B. Conclusion: Tonsillectomy with bipolar electro dissection method ismuch better than cold steel dissection method. It has an advantage of less blood loss duringsurgery. It significantly reduces intra operative time.

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Managing Sacral Giant Cell Tumor with Surgery and Various Adjuvant Therapies

10.21203/rs.3.rs-53987/v1 ◽

2020 ◽

Author(s):

Yushen Zhang ◽

Jun Fu ◽

Yingsen Xue ◽

Zheng Guo ◽

Zhen Wang ◽

...

Keyword(s):

Blood Loss ◽

Giant Cell Tumor ◽

Giant Cell ◽

Recurrence Rate ◽

Operation Time ◽

Arterial Embolization ◽

Cell Tumor ◽

Adjuvant Therapies ◽

Group A ◽

Group B

Abstract Background and purpose: There is no consensus regarding the appropriate treatment of sacral giant cell tumor (SGCT). This study is to compare oncological and neurological outcomes of SGCT managed by surgery and various adjunctive therapies.Methods: A total of 31 patients with SGCT were retrospectively studied. They were divided into two Groups. A: 13 patients underwent surgery plus SAE and radiotherapy; Group B: 18 patients underwent surgery plus one arterial embolization and denosumab. The postoperative functional outcomes, recurrence, mortality, and complications were compared.Results: The mean operation time (231±49min) and blood loss (3167±856mL) of group B were significantly less than those of group A (283±41min, 5054±689mL) (p<0.05). The average follow-up was 68.5 months. The neurologic function scores showed no significant difference. The recurrence rate of group B (11.2%) was much lower than that of group A (30.7%, p=0.17). The cumulative survival rate of group B was higher than that of group A (p=0.133).Conclusions: In comparison to other adjuvant therapies, one arterial embolization plus denosumab can reduce the intra-operative blood loss, shorten the operation time, and decrease the recurrence rate in patients with SGCT.

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Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2891-7 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Yanping Zeng ◽

Peng Cheng ◽

Jiulin Tan ◽

Zhilin Li ◽

Yuan Chen ◽

...

Keyword(s):

Retrospective Study ◽

Blood Loss ◽

Operation Time ◽

Neurological Deficits ◽

Thoracolumbar Junction ◽

Surgical Approaches ◽

Instrumented Fusion ◽

Group A ◽

Group B ◽

Multicentre Retrospective Study

Abstract Background The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. Forty-five patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals. Results All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2 ± 45.4 min, 408.0 ± 54.3 min, 227.9 ± 58.5 min, and the blood loss was 744.0 ± 193.8 ml, 1134.6 ± 328.2 ml, 349.8 ± 289.4 ml in groups A, B and C respectively. The average loss of correction was 5.5 ± 3.7° in group A, 1.6 ± 1.9° in group B, 1.7 ± 2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.

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Comparison of anterior transthoracic debridement and fusion with posterior transpedicular debridement and fusion in the treatment of mid-thoracic spinal tuberculosis in adults

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2945-x ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Weiwei Li ◽

Zheng Liu ◽

Xiao Xiao ◽

Zhen Zhang ◽

Xiyang Wang

Keyword(s):

Blood Loss ◽

Spinal Tuberculosis ◽

Operation Time ◽

Kyphosis Angle ◽

Vas Score ◽

Thoracic Spinal ◽

Sf 36 ◽

Group A ◽

Group B ◽

Thoracic Spinal Tuberculosis

Abstract Background The surgical procedures for mid-thoracic spinal tuberculosis mainly include anterior transthoracic debridement and fusion and posterior transpedicular debridement and fusion. Until now, the surgical choice is still controversial. This study aims to compare the clinical efficacy of anterior transthoracic debridement and fusion with posterior transpedicular debridement and fusion in the treatment of mid-thoracic (T5–9) spinal tuberculosis in adult patients. Methods Eighty-seven cases with mid-thoracic spinal tuberculosis were treated with anterior transthoracic debridement and fusion (Group A, n = 39) and posterior transpedicular debridement and fusion (Group B, n = 48) from January 2007 to June 2014. Parameters including the operation time, blood loss, time of ESR and CRP decreasing to the normal level, time of abscess disappearance, time of bone graft fusion, rate of surgical complications, Visual Analog Scale (VAS) score, kyphosis angle and SF-36 scale were compared between two groups to evaluate their therapeutic effects. Results All patients were followed up for 5–10 years with the mean of 6.2 ± 1.1 years. No significant differences were observed regarding the gender composition ratio, age, course of disease, number of lesion segments, and preoperative indexes of ESR, CRP, VAS score, kyphosis angle and SF-36 scale between the two groups. Besides, no significant differences were observed regarding VAS score, kyphosis angle and SF-36 scale between the two groups in the 5th postoperative year (P > 0.05). However, the operation time (158.2 ± 10.7 min vs. 183.7 ± 14.1 min), blood loss (517.9 ± 76.5 ml vs.714.6 ± 57.4 ml), time of ESR (2.3 ± 1.1 months vs.3.1 ± 1.4 months) and CRP (1.1 ± 0.3 months vs.1.2 ± 0.6 months) decreasing to the normal level, time of abscess disappearance (2.7 ± 1.6 months vs.4.9 ± 1.9 months), and time of bone graft fusion (6.6 ± 0.8 months vs.8.0 ± 9.6 months) in Group A were less than those in Group B (P < 0.05). Conclusions Both anterior transthoracic debridement and fusion and posterior transpedicular debridement and fusion have a low risk of surgical complications and provide good quality of life for the patients with mid-thoracic (T5–9) spinal tuberculosis followed up in the mid-term. Moreover, the anterior procedure leads to early resolution of the disease and faster fusion.

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A Simple Technique to Reduce Blood Loss and Improve Cosmesis in Varicose Vein Surgery

Phlebology The Journal of Venous Disease ◽

10.1177/026835559801300405 ◽

1998 ◽

Vol 13 (4) ◽

pp. 153-156

Author(s):

A. Rehman ◽

V. S. P. Rallapalle ◽

R. Iqbal ◽

R. P. Grimley ◽

A. P. Jayatunga

Keyword(s):

Blood Loss ◽

Varicose Vein ◽

Varicose Veins ◽

Operation Time ◽

Cosmetic Result ◽

Compression Stocking ◽

Varicose Vein Surgery ◽

Cosmetic Results ◽

Group A ◽

Group B

Objective: To assess the effectiveness of preoperative compression hosiery in reducing blood loss during surgery for varicose veins and improving cosmetic results. Setting: Vascular Surgical Unit, Dudley Group of Hospitals NHS Trust, West Midlands, UK. Design: Randomized, single-blind, prospective, controlled trial. Patients: Thirty-nine patients with varicose veins in 50 legs. Intervention: Group A, the control group ( n = 19), were given compression stockings on the first postoperative day after the bandages were removed. Group B, the study group ( n = 20), used compression stocking 24 h before surgery as well as in the postoperative period. The surgical procedure was standardized. Main outcome measures: Blood loss, weight of veins removed, operation time and cosmetic result after 6 weeks. Results: In group B, patients were noted to have reduced blood loss, a shorter operation time and a greater weight of avulsed veins. Poor cosmetic results were recorded in group A. Conclusions: Preoperative emptying of veins by using a compression stocking is useful in reducing blood loss and improving the cosmetic result after routine varicose vein surgery.

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