Focal meato-mastoid fistula closure using bony sigmoid sinus plate

2022 ◽  
pp. 1-24
Author(s):  
Indorewala Shabbir ◽  
Kartik Parelkar ◽  
Indorewala Abuzar ◽  
Mahajan Gauri ◽  
Shere Devika
Keyword(s):  
Sigmoid Sinus ◽  
Fistula Closure

A Giant Right Coronary Artery of Diffuse Ectasia Induced by a Right Ventricular Fistula

2015 ◽  
Vol 18 (6) ◽  
pp. 253
Author(s):  
Renyuan Li ◽  
Yiming Ni ◽  
Peng Teng ◽  
Weidong Li
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Artery Bypass ◽  
Coronary Artery Fistula ◽  
Rare Entity ◽  
Fistula Closure ◽  
Unique Case ◽  
Coronary Ectasia ◽  
The Right ◽  
Giant Size

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>

scholarly journals Versatility of the pedicled buccal fat pad flap for the management of oroantral fistula: a retrospective study of 25 cases

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Jinyoung Park ◽  
Byung-do Chun ◽  
Uk-Kyu Kim ◽  
Na-Rae Choi ◽  
Hong-Seok Choi ◽  
...  
Keyword(s):  
Bone Graft ◽  
Graft Failure ◽  
Fistula Closure ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Dental Surgery ◽  
Female Ratio ◽  
Maxillary Bone ◽  
Oroantral Fistula

Abstract Purpose Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

scholarly journals Fully automated preoperative segmentation of temporal bone structures from clinical CT scans

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
C. A. Neves ◽  
E. D. Tran ◽  
I. M. Kessler ◽  
N. H. Blevins
Keyword(s):  
Facial Nerve ◽  
Inner Ear ◽  
Temporal Bone ◽  
Hausdorff Distance ◽  
Sigmoid Sinus ◽  
Ct Scans ◽  
Automated Segmentation ◽  
Dice Coefficient ◽  
Lateral Skull Base ◽  
End To End

AbstractMiddle- and inner-ear surgery is a vital treatment option in hearing loss, infections, and tumors of the lateral skull base. Segmentation of otologic structures from computed tomography (CT) has many potential applications for improving surgical planning but can be an arduous and time-consuming task. We propose an end-to-end solution for the automated segmentation of temporal bone CT using convolutional neural networks (CNN). Using 150 manually segmented CT scans, a comparison of 3 CNN models (AH-Net, U-Net, ResNet) was conducted to compare Dice coefficient, Hausdorff distance, and speed of segmentation of the inner ear, ossicles, facial nerve and sigmoid sinus. Using AH-Net, the Dice coefficient was 0.91 for the inner ear; 0.85 for the ossicles; 0.75 for the facial nerve; and 0.86 for the sigmoid sinus. The average Hausdorff distance was 0.25, 0.21, 0.24 and 0.45 mm, respectively. Blinded experts assessed the accuracy of both techniques, and there was no statistical difference between the ratings for the two methods (p = 0.93). Objective and subjective assessment confirm good correlation between automated segmentation of otologic structures and manual segmentation performed by a specialist. This end-to-end automated segmentation pipeline can help to advance the systematic application of augmented reality, simulation, and automation in otologic procedures.

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Anterior Position ◽  
Multiparous Women ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas

Abstract Background Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre. Methods Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively. Results Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure. Conclusions In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out. Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.

Transmastoid Hydroxyapatite Resurfacing for Sigmoid Sinus Wall Anomalies Causing Pulsatile Tinnitus

2021 ◽  
pp. 000348942098740
Author(s):  
Ian Newberry ◽  
Julie Highland ◽  
Alvin DeTorres ◽  
Richard Gurgel
Keyword(s):  
Case Series ◽  
Sigmoid Sinus ◽  
Pulsatile Tinnitus ◽  
Retrospective Case ◽  
Tertiary Referral Center ◽  
Operative Outcomes ◽  
Sinus Wall ◽  
Objective Tinnitus ◽  
Materials Used

Objective: Comprising 4% of tinnitus, pulsatile tinnitus (PT) can be particularly difficult for affected patients as well as surgeons looking to address their symptoms. Often the cause is not identified but can be secondary to turbulent flow in or near the sigmoid sinus, particularly if there is an identifiable sigmoid sinus dehiscence (SSDe) and/or diverticulum (SSDi). These sigmoid sinus wall anomalies (SSWA) may be treated with transmastoid sigmoid sinus resurfacing; however, this intervention remains relatively novel and its technique, materials used, resolution success, and complications need to be continuously reviewed. Methods: A retrospective case series of patients with PT due to SSWA at a tertiary referral center was reviewed. A total of 6 patients (7 ears) treated by transmastoid resurfacing using hydroxyapatite (HA) were retrospectively assessed. Pre-operative demographics and symptoms, pre- and post-operative hearing results, and post-operative outcomes were reviewed. Results: All patients were female with an average BMI of 32.9 (±5.4) and a mean age of 45.5 years (±15.3). Mean follow-up was 648 days. Objective tinnitus was noted in all ears with SSDi (100%); however, no objective tinnitus was noted with purely SSDe. In 100% of ears, PT was diminished with ipsilateral jugular compression and was amplified with contralateral head turn. Pre-operative symptoms of PT resolved in all patients, but delayed recurrence (>1 year) occurred in 1 ear (14%). No patient had pre- or post-operative hearing loss. No major complications were encountered. Conclusions: Transmastoid resurfacing for SSWA with HA bone cement is a safe, reliable intervention in properly identified PT patients.

Transvenous Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Santiago Gomez-Paz ◽  
Yosuke Akamatsu ◽  
Mohamed M Salem ◽  
Justin M Moore ◽  
Ajith J Thomas ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
External Carotid Artery ◽  
Sigmoid Sinus ◽  
Definitive Treatment ◽  
External Carotid ◽  
Type I ◽  
Patient Consent

Abstract This case is a 66-yr-old woman with a 2-mo history of left-sided tinnitus. Workup with magnetic resonance angiography showed early opacification of the left sigmoid sinus and internal jugular vein as well as asymmetric and abundant opacification of the left external carotid artery branches, suspicious for a dural arteriovenous fistula (dAVF). Diagnosis was confirmed with cerebral angiography, consistent with a left-sided Cognard type I dAVF.1 Initial treatment attempt was made with transarterial 6% ethylene-vinyl alcohol copolymer (Onyx 18) embolization of feeders from the occipital and middle meningeal arteries. However, embolization was not curative and there was a recurrence of a highly bothersome tinnitus 3 wk following treatment. Angiography redemonstrated the transverse sinus dAVF with new recruitment arising from several feeders, including the left external carotid artery, middle meningeal artery, and superficial temporal artery, now Cognard type IIa. Definitive treatment through a transvenous coil embolization provided permanent obliteration of the fistula without recrudescence of symptoms on follow-up. In this video, the authors discuss the nuances of treating a dAVF via a transvenous embolization. Patient consent was given prior to the procedure, and consent and approval for this operative video were waived because of the retrospective nature of this manuscript and the anonymized video material.

scholarly journals Retrieval of a migrated N-butyl-2 cyanoacrylate cast using a snare-kit system during dural AVF embolization: A case report

2018 ◽  
Vol 24 (5) ◽  
pp. 571-573
Author(s):  
Ramy Ahmed ◽  
Satomi Ide ◽  
Hiro Kiyosue ◽  
Shuichi Tanoue ◽  
Shunro Matsumoto ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Endovascular Procedures ◽  
Sigmoid Sinus ◽  
Embolic Material ◽  
Coagulation Profile ◽  
Liquid Embolic

N-butyl-2 cyanoacrylate (NBCA) is a liquid embolic material that is widely used in various endovascular procedures because of its permanent and rapid vascular occluding effect regardless of the coagulation profile of the patient. However, NBCA migration to unintended vessels may result in serious complications. This report describes the retrieval of a migrated NBCA cast from the transverse-sigmoid sinus during dural arteriovenous fistula embolization using a transvenous snaring technique.

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