Survival and function following pharyngo-laryngo-oesophagectomy in Wales: a twelve-year case series

2021 ◽  
pp. 1-5
Author(s):  
D R Edwards ◽  
L Pope ◽  
S Berry
Keyword(s):  
Functional Outcome ◽  
Locally Advanced ◽  
Case Series ◽  
Disease Free Survival ◽  
Late Toxicity ◽  
Hypopharyngeal Cancer ◽  
Voice Rehabilitation ◽  
Retrospective Case ◽  
And Function

Abstract Objective Treatment of locally advanced hypopharyngeal cancer can cause significant morbidity and late toxicity. Pharyngo-laryngo-oesophagectomy can achieve adequate surgical margins, but data on survival and functional outcome are limited, especially in Wales. This study aimed to describe mortality, morbidity and functional outcome following pharyngo-laryngo-oesophagectomy in a Welsh population. Method This study was a retrospective case note review of pharyngo-laryngo-oesophagectomy cases in Wales over 12 years. Results Fifteen patients underwent pharyngo-laryngo-oesophagectomy; all but one underwent gastric pull-up. Median survival and disease-free survival were 17 months (range, 2–53 months) and 14 months. Censored 3-month, 1-year and 3-year survival was 93, 71 and 50 per cent, respectively. Common Terminology Criteria for Adverse Events grading of long-term dysphagia was 1 in 58 per cent, 2 in 33 per cent and 3 in 8 per cent, and 87.5 per cent achieved a ‘moderate’ or ‘good’ voice rehabilitation. Conclusion These results demonstrate favourable survival and reasonable functional outcome following pharyngo-laryngo-oesophagectomy, suggesting pharyngo-laryngo-oesophagectomy should be considered in all appropriate surgical candidates.

scholarly journals Long Term Clinical and Functional Outcome of Distally Based Sural Artery Flap: A Retrospective Case Series

JPRAS Open ◽  
2021 ◽  
Author(s):  
Pervaiz Mehmood Hashmi ◽  
Abeer Musaddiq ◽  
Muhammad Ali ◽  
Alizah Hashmi ◽  
Marij Zahid ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Sural Artery ◽  
Distally Based

scholarly journals Management and Outcome of Hindfoot Trauma With Concomitant Talar Head Injury

2021 ◽  
pp. 107110072098002
Author(s):  
Esmee Wilhelmina Maria Engelmann ◽  
Olivier Wijers ◽  
Jelle Posthuma ◽  
Tim Schepers
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Ankle Injuries ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Long Term Outcome ◽  
Talar Head ◽  
The Mean

Background: Talar head fractures account for 2.6% to 10% of all talar fractures and are often associated with concomitant musculoskeletal injuries. The current literature only describes a total of 14 patients with talar head fractures and, with that, guidelines for management are lacking. The aim of the current study was to evaluate the management and long-term outcome of patients who have hindfoot trauma with concomitant talar head fractures. Methods: This study includes a retrospective cohort of patients with talar head fractures. Patient characteristics, trauma mechanism, fracture characteristics, treatment, follow-up, and complications were reported. Functional outcome was assessed using the Foot Function Index (FFI) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Quality of life was measured by the EuroQol-5D (EQ-5D). Twenty-one patients with acute fractures of the talar head were identified. The mean follow-up time was 4.9 years. Results: All patients sustained additional ipsilateral foot and/or ankle injuries. Fifteen patients had operative management of their talar head fracture. There were no postoperative wound infections and no cases of avascular necrosis. All fractures united, and 29% of patients developed posttraumatic osteoarthritis. The overall mean FFI score index was 34.2, and the mean AOFAS score was 70.7. The mean EQ-5D index score was 0.74. Conclusion: Talar head fractures always coincided with other (foot) fractures. Management and long-term functional outcome were affected by the extent of associated injuries. Due to the low incidence and high complexity of talar head fractures, early referral to dedicated foot surgeons and centralization of complex foot surgery is recommended. Level of Evidence: Level IV, retrospective case series.

Long-term functional outcome after traumatic lumbosacral dissociation. A retrospective case series of 13 patients

Injury ◽  
2016 ◽  
Vol 47 (7) ◽  
pp. 1562-1568 ◽  
Author(s):  
Aron Adelved ◽  
Anna Tötterman ◽  
Thomas Glott ◽  
Johan C. Hellund ◽  
Jan Erik Madsen ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series

Ultra-low-dose radiation treatment for early-stage ocular adnexal MALT lymphoma

2021 ◽  
pp. 112067212110356
Author(s):  
Min Joung Lee ◽  
Me Yeon Lee ◽  
Ji-Young Choe ◽  
Se Hyun Choi ◽  
Hyo Jung Kim
Keyword(s):  
Malt Lymphoma ◽  
Low Dose ◽  
Radiation Treatment ◽  
Early Stage ◽  
Case Series ◽  
Disease Free Survival ◽  
Response To Treatment ◽  
Retrospective Case

Purpose: To investigate the long-term outcomes of ultra-low-dose (4 Gy) radiation treatment (RT) in patients with early-stage ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: This retrospective case series includes eight patients with ocular adnexal MALT lymphoma who received ultra-low-dose RT at a single tertiary referral center between March 2016 and February 2018. Response to treatment and the time taken to respond were analyzed. Results: Of the eight patients (three men, five women), seven patients had conjunctival lymphoma (T1N0M0), and one patient had orbital lymphoma (T2N0M0). Six patients with T1 disease showed complete response (CR), and the median time to CR was 4.5 months (range 2–5). Partial response was achieved in the remaining two patients (one each with T1 and T2). During the median follow-up period of 44 months (range 30–54), none of the patients had a relapse or needed additional treatment. RT was well-tolerated in all patients with no ocular complications, including cataracts and dry eye. Conclusion: This case series suggests that ultra-low-dose RT is effective and well-tolerated in patients with early-stage ocular adnexal MALT lymphoma. Further studies with a larger sample size and long-term follow-up are needed to evaluate the local control rate and disease-free survival precisely.

scholarly journals A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1474
Author(s):  
Stefan Grasl ◽  
Elisabeth Schmid ◽  
Gregor Heiduschka ◽  
Markus Brunner ◽  
Blažen Marijić ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Classification System ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Previous Treatment ◽  
Extent Of Resection ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Oral Nutrition

(1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

2021 ◽  
pp. 194338752110264
Author(s):  
Sean A. Knudson ◽  
Kristopher M. Day ◽  
Patrick Kelley ◽  
Pablo Padilla ◽  
Ian X. Collier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Planning ◽  
Average Length ◽  
Case Series ◽  
Retrospective Case ◽  
Oral Nutrition ◽  
Microsurgical Reconstruction ◽  
Virtual Surgical Planning ◽  
And Function ◽  
Ballistic Trauma

Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

Long-Term Stability After Regenerative Treatment of Infrabony Defects: A Retrospective Case Series

2017 ◽  
Vol 88 (6) ◽  
pp. 536-542 ◽  
Author(s):  
Katrin Nickles ◽  
Bettina Dannewitz ◽  
Kerstin Gallenbach ◽  
Tatjana Ramich ◽  
Susanne Scharf ◽  
...  
Keyword(s):  
Case Series ◽  
Retrospective Case ◽  
Term Stability ◽  
Long Term Stability ◽  
Retrospective Case Series ◽  
Infrabony Defects

scholarly journals Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary
Keyword(s):  
Case Series ◽  
Surgical Reconstruction ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Retrospective Case ◽  
Penile Fracture ◽  
Case Series Study ◽  
Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

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