Treatment strategies for inverted papillomas with intracranial or intraorbital involvement

2021 ◽  
pp. 1-7
Author(s):  
D Spinos ◽  
T Kalamatianos ◽  
D Terzakis ◽  
M Piagkou ◽  
C Georgalas
Keyword(s):  
Demographic Data ◽  
Treatment Strategies ◽  
Case Series ◽  
Recurrence Rates ◽  
Case Series Study ◽  
Patient Demographic Data ◽  
Complete Tumour ◽  
Prospective Case Series ◽  
Benign Tumours ◽  
Inverted Papillomas

Abstract Objective Sinonasal inverted papillomas are challenging benign tumours of the nasal cavity because of their high recurrence rates and the lifetime malignant transformation risk of 10 per cent as well as their locally aggressive behaviour. This study aimed to describe treatment strategies for inverted papillomas with intracranial or intraorbital involvement. Method This was a prospective case series study of 18 patients with inverted papilloma with intracranial or intraorbital involvement. Patient demographic data, imaging, pathology, surgical technique and recurrences were recorded prospectively over a period of seven years. Results A total of 83 per cent of the patients in this study had been previously operated on, consisting of 8 cases with intracranial involvement, 1 case with intraorbital involvement and 9 with both. During follow up with a medium of 37 months (range, 13–115 months) there were two recurrences. Conclusion It was postulated that intracranial or intraorbital involvement observed in this series was the result of multiple revisions. However, using accurate imaging protocols and the pedicle-oriented approach for tumour excision, complete tumour removal was achieved in most cases with minimal post-operative complications.

Clinical Outcomes of Endoscopic and Endoscopic-Assisted Resection of Inverted Papillomas: A 15-Year Experience

2007 ◽  
Vol 21 (5) ◽  
pp. 591-600 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Geeta A. Bhargave ◽  
James N. Palmer ◽  
Alexander G. Chiu ◽  
Noam A. Cohen ◽  
...  
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
Care Facility ◽  
Recurrence Rates ◽  
Time To Recurrence ◽  
Tertiary Care Facility ◽  
Inverted Papillomas

Background The endoscopic resection of sinonasal inverted papillomas (IPs) has been well described. However, the majority of published reports in the literature are small case series with limited clinical follow-up. The aim of this retrospective study was to review the experience with the endoscopic and endoscopic-assisted resection of IPs at a major academic tertiary care facility and assess long-term outcomes. Methods A retrospective review of endoscopic and endoscopic-assisted resections of IP was performed. Charts were reviewed for standard demographic data, operative technique, adjuvant approaches, complications, and postoperative follow-up times. Results One hundred fourteen patients (average age, 56 years) underwent endoscopic or endoscopic-assisted resection for IPs with a mean disease-free follow-up of 40 months (7–135 months). Seventeen patients developed disease after endoscopic or endoscopic-assisted resection for a recurrence rate of 15%. Average time to recurrence was 23 months. Combined approaches were used when indicated in 34% (39/114) of patients, including adjuvant osteoplastic flap, midface degloving, trephine, or Caldwell-Luc approaches. Four patients (4%) had cerebrospinal fluid leaks that were successfully repaired endoscopically. Conclusion In this large series of endoscopically resected IPs with extensive clinical follow-up, recurrences occurred an average of 23 months after the procedure. This emphasizes the importance of long-term endoscopic follow-up to detect recurrences in all patients. Endoscopic or endoscopic-assisted resection of IPs is a valid technique in this series with recurrence rates comparable with open approaches.

scholarly journals The Effect of HbA1c Variability as a Risk Measure for Microangiopathy in Type 1 Diabetes Mellitus

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1151
Author(s):  
Pedro Romero-Aroca ◽  
Raul Navarro-Gil ◽  
Albert Feliu ◽  
Aida Valls ◽  
Antonio Moreno ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Type 1 Diabetes Mellitus ◽  
Risk Measure ◽  
Case Series ◽  
Multivariate Statistical ◽  
Case Series Study ◽  
Prospective Case Series

Background: To measure the relationship between variability in HbA1c and microalbuminuria (MA) and diabetic retinopathy (DR) in the long term. Methods: A prospective case-series study, was conducted on 366 Type 1 Diabetes Mellitus patients with normoalbuminuria and without diabetic retinopathy at inclusion. The cohort was followed for a period of 12 years. The Cox survival analysis was used for the multivariate statistical study. The effect of variability in microangiopathy (retinopathy and nephropathy) was evaluated by calculating the standard deviation of HbA1c (SD-HbA1c), the coefficient of variation of HbA1c (CV-HbA1c), average real variability (ARV-HbA1c) and variability irrespective of the mean (VIM-HbA1c) adjusted for the other known variables. Results: A total of 106 patients developed diabetic retinopathy (29%) and 73 microalbuminuria (19.9%). Overt diabetic nephropathy, by our definition, affected only five patients (1.36%). Statistical results show that the current age, mean HbA1c, SD-HbA1c and ARV-HbA1c are significant in the development of diabetic retinopathy. Microalbuminuria was significant for current age, mean HbA1c, CV-HbA1c and ARV-HbA1c. Conclusions: By measuring the variability in HbA1c, we can use SD-HbA1c and ARV-HbA1c as possible targets for judging which patients are at risk of developing DR and MA, and CV-HbA1c as the target for severe DR.

scholarly journals Treatment of digital ulcers in systemic sclerosis: Case series study of thirteen patients and discussion on outcome

2017 ◽  
Vol 63 (5) ◽  
pp. 422-426 ◽  
Author(s):  
Yahia Abuowda ◽  
Raquel Sousa Almeida ◽  
Ana Alves Oliveira ◽  
Petra Pego ◽  
Cristina Santos ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Case Series ◽  
Tissue Loss ◽  
Repeated Treatment ◽  
Digital Ulcers ◽  
Case Series Study ◽  
Clinical Description ◽  
Soft Tissue Loss

Summary Introduction: In systemic sclerosis (SSc), digital ulcers (DU) are debilitating and recurrent. They are markers of prognosis and are associated with disability and mortality. Treatment strategies have been developed to block the proposed mechanisms of this complication. Objective: Clinical description of a population of SSc patients with DU, treatment, complications and outcome. Method: Analysis of 48 SSc patients meeting 2013 ACR-EULAR criteria, followed between 1999-2015; 13 patients had DU. Treatment protocol applied included cycles of 21 days of alprostadil, which can be repeated in the absence of DU healing. After DU healing, bosentan was initiated. Results: DU healing was achieved with intravenous prostanoid in 12 patients; seven patients required repeated treatment for DU healing. Twelve patients were later treated with bosentan; three of them experienced recurrence of DU, while one was anti-B2-GPI positive. Four patients had soft tissue loss and three other suffered digital amputation, these being late diagnosis. Conclusion: Younger patients and early referrals had better outcomes. Endothelin receptor antagonist toxicity should be monitored, particularly in patients previously exposed to hepatotoxic drugs.

High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study

2017 ◽  
Vol 33 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Filipe Jaeger ◽  
Gustavo Marques Chiavaioli ◽  
Guilherme Lacerda de Toledo ◽  
Belini Freire-Maia ◽  
Marcio Bruno Figueiredo Amaral ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Case Series ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Case Series Study ◽  
Prospective Case Series ◽  
Power Diode ◽  
Series Study ◽  
High Power Diode Laser ◽  
Le Fort I

scholarly journals IDH1 Mutation in Gliomas in Mosul City - Iraq

2015 ◽  
Vol 3 (2) ◽  
pp. 250-255 ◽  
Author(s):  
Mohammed Sami Saeed
Keyword(s):  
Case Series ◽  
Idh1 Mutation ◽  
Teaching Hospitals ◽  
Low Grade ◽  
Isocitrate Dehydrogenase 1 ◽  
Secondary Glioblastoma ◽  
Idh1 R132h ◽  
Case Series Study ◽  
Idh1 Mutations ◽  
Prospective Case Series

BACKGROUND: IDH1 (isocitrate dehydrogenase 1) mutation might be encounter in the low grade glioma and directs the progression of the tumor to a higher grade.OBJECTIVE: To assess the frequency of IDH1 mutations in gliomas and to correlate the IDH1 positivity with the type and grade of tumors, the age and sex of the patients.MATERIAL AND METHODS: A retro– and prospective case series study. One hundred and nine cases of intracranial gliomas were collected between 2008 and 2014 from Mosul Private Laboratories and Al-Jamboree Teaching Hospitals in Mosul. IDH1 mutations were assessed immunohistochemically using anti-IDH1 R132H mouse monoclonal antibody.RESULTS: IDH1 mutation was perceived in 34.86% of gliomas. In adult gliomas, the secondary glioblastoma and the low-grade astrocytoma had the greatest values of IDH1 positivity (88.88% and 62.5% respectively), followed by oligoastrocytoma/oligodendroglioma (50.0%), and anaplastic astrocytoma (47.36%). The primary glioblastomsa showed 17.64% IDH1 positivity. Males and females expressed the IDH1 equally. While, there was no role of IDH1 in pediatric gliomas.CONCLUSION: IDH1 mutation is commonly present in adult gliomas particularly in low-grade gliomas, and secondary glioblastoma, with equal sex distribution, but it has no role in pediatric gliomas.

Surgical Management of Stylohyoid Pain (Eagle’s) Syndrome: A 5-Year Experience

2018 ◽  
Vol 128 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Candace M. Waters ◽  
Sandra Ho ◽  
Adam Luginbuhl ◽  
Joseph M. Curry ◽  
David M. Cognetti
Keyword(s):  
Demographic Data ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pain Syndrome ◽  
Eagle’S Syndrome ◽  
Presenting Symptoms ◽  
Patient Symptom ◽  
Symptom Scores ◽  
Wide Variability ◽  
Prospective Case Series

Objectives: (1) To define patient demographics and common symptoms in patients who undergo styloidectomy for stylohyoid pain syndrome (Eagle’s syndrome). (2) To evaluate the effectiveness of styloidectomy in reducing symptoms of Eagle’s syndrome. Methods: Retrospective chart review and prospective case series. We retrospectively gathered demographic data on all patients at a single institution who underwent styloidectomy during a 5-year period. Using a patient symptom survey, we also gathered prospective data on a cohort of these patients presenting during the second half of the timeframe. Results: Thirty-two patients underwent styloidectomy for Eagle’s syndrome between November 2010 and June 2015. Of these patients, 22 (68.8%) were female, 29 (90.6%) were Caucasian, and 10 (31.3%) reported history of tonsillectomy. Mean age was 46.0 years, and mean BMI was 26.1 kg/m2. Nineteen patients completed the prospective survey. Average styloid length was 45.3 mm. Most severe preoperative symptoms were neck pain, otalgia, globus, facial pain, headache, and discomfort with neck turning. Thirteen of 17 individual symptoms demonstrated significant decrease in symptom scores after styloidectomy. Aggregate symptom scores also showed significant decrease postsurgically. Longer styloid length correlated with increased scores for dysphagia and odynophagia but not with conglomerate symptom scores. Conclusions: Patients with Eagle’s syndrome were mostly female, Caucasian, and had near-normal BMI. There is wide variability in presenting symptoms of Eagle’s syndrome, but nearly all demonstrate improvement after styloidectomy. Thus, in appropriately selected patients, styloidectomy can effectively and reliably produce improvement in patient symptoms.

scholarly journals PAROTID SWELLING IN CHILDREN

2009 ◽  
Vol 16 (01) ◽  
pp. 38-43
Author(s):  
ABID HAMEED SHEIKH ◽  
EHSAN UL HAQ ◽  
MUHAMMAD ZULFIQAR ANJUM ◽  
Gulzar Ahmad
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Cystic Hygroma ◽  
Vascular Lesions ◽  
Paediatric Surgery ◽  
Malignant Tumours ◽  
Parotid Region ◽  
Case Series Study ◽  
Parotid Swelling ◽  
Benign Tumours

Objective: To describe the clinical and pathological presentation as well as treatment options of parotid swelling inchildren. D e s i g n : Descriptive case series study. S e t t i n g : Department of Paediatric Surgery Bahawal Victoria Hospital Bahawalpur. Period:From Nov2005 to Jul2007. Material a n d m e t h o d : All patients of either sex below the age of 13 years presenting with parotid swelling wereincluded in the study. Clinical presentations, preoperative investigations, operative procedures, histopathology reports, postoperativecomplications and further management (radiotherapy &chemotherapy) were recorded. Results: Twelve patients presented with parotidswelling. Commonest presentation was a lump over the parotid region (100%) & pain (25%). Majority of tumours were benign (50%).Vascular lesions outnumbered solid tumours. 4 patients (33.33%) had haemangioma 1 patient (8.33%) had cystic hygroma, one patienteach of pleomorphic adenoma, mucoepidermoid carcinoma and Adenocarcinoma. C o n c l u s i o n : Salivary gland lesions are most likelyinflammatory in origin. Vascular tumours are common benign tumours than epithelial tumours in children. Superficial parotidectomy is theoperation for benign tumours and total conservative parotidectomy for malignant tumours.

Mono-Unit Alar Rim Graft Technique for Tip-Alar Margin Support

2020 ◽  
Vol 40 (10) ◽  
pp. NP588-NP596
Author(s):  
Shin Ae Kim ◽  
Yong Ju Jang
Keyword(s):  
Demographic Data ◽  
Costal Cartilage ◽  
Case Series ◽  
Senior Author ◽  
Open Approach ◽  
Level Of Evidence ◽  
Appropriate Treatment ◽  
Patient Demographic Data ◽  
Patient Series ◽  
Alar Rim

Abstract Background The appropriate treatment of alar rim deformities, such as alar pinching or concavity, and soft triangle notching is essential for perfecting nasal aesthetics. Objectives The authors introduced the “mono-unit alar rim graft” technique as a treatment option for these abnormalities. Methods A case series of 29 rhinoplasties conducted by the senior author between May 2017 and June 2019 utilizing the mono-unit alar rim graft technique was retrospectively reviewed. The surgical technique involved an open approach with costal cartilage harvesting. The cortical portion of the harvested costal cartilage was sectioned into a 1-mm-thick strip and soaked with saline for about 15 minutes to let the natural warping occur. The curved cartilage graft was then trimmed, and the midportion was sutured to the tip in an onlay fashion. Both ends of the graft were housed in the vestibular pocket. Patient demographic data and pre- and postoperative facial photos were reviewed. Results Among the 29 cases analyzed, 14 (48.3%) were men and 15 (51.7%) were women. Ten (34.5%) patients had a preoperative parenthesis deformity, but a near-complete correction was achieved in 8 (80.0%) cases. An alar concavity from the basal view was found in 16 patients, 15 (93.8%) of whom had a partial or near-complete correction. Eleven patients had soft triangle notching, 9 (81.8%) of whom had a partial or near-complete correction. There were no technique-related complications in this patient series. Conclusions The mono-unit alar rim graft technique is a viable option for treating various alar rim deformities. Level of Evidence: 4

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