scholarly journals Radial bone graft usage for nasal septal reconstruction

2011 ◽  
Vol 44 (01) ◽  
pp. 036-040
Author(s):  
Yakup Cil ◽  
Atacan Emre Kocman ◽  
Abdul Kerim Yapıci ◽  
Serdar Ozturk
Keyword(s):  
Bone Graft ◽  
Operation Time ◽  
Saddle Nose ◽  
Corrective Surgery ◽  
Secondary Surgery ◽  
Crooked Nose ◽  
Septal Surgery ◽  
The Mean ◽  
Radial Bone

ABSTRACT Background: Although various techniques have been described for correction of crooked and saddle nose deformities, these problems are challenging with high recurrence and revision rates. Conventional septal surgery may not be adequate for nose reconstruction in crooked and saddle nose deformities. Materials and Methods: Between December 2005 and October 2009, six patients with crooked nose and five patients with saddle nose deformities underwent corrective surgery in our clinic. All patients were male, and the mean age was 21 years (range, 19-23 years). We used rigid radial bone graft to prevent redeviation and recurrence following corrective nasal septal surgery. Results: The mean follow-up period was 28 months, ranging from 18 to 46 months. Mean operation time was 4 hours (3-4.5). All patients healed uneventfully. None of the patients required secondary surgery. Conclusions: We believe that radial bone grafts offer a long lasting support in treatment of challenging cases with crooked and saddle nose deformities.

Wrist Arthrodesis with Excision of the Proximal Carpal Bones Using the AO/ASIF Wrist Fusion Plate and Local Bone Graft

2001 ◽  
Vol 26 (3) ◽  
pp. 247-251 ◽  
Author(s):  
B. J. HARTIGAN ◽  
D. J. NAGLE ◽  
M. J. FOLEY
Keyword(s):  
Clinical Outcome ◽  
Bone Graft ◽  
Carpal Bones ◽  
Secondary Surgery ◽  
Wrist Arthrodesis ◽  
Local Bone ◽  
Outcome Scores ◽  
Wrist Fusion ◽  
The Mean

We present our series of 17 patients who underwent wrist arthrodesis with excision of the proximal row carpal bones using the AO wrist fusion plate and local bone graft obtained from the excised proximal carpal row. All patients were evaluated using a questionnaire to assess pain, function, ability to perform an occupation and satisfaction with the procedure. The mean follow-up was 17 months, at which time all the fusions had united. Clinical outcome scores showed that 14 and 15 of the 17 patients achieved good or excellent results with regard to their current condition and clinical improvement, respectively. Four patients required secondary surgery, two for fractures and two for instability of the distal radio-ulnar joint unrelated to the wrist fusion.

scholarly journals Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

scholarly journals Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

2015 ◽  
Vol 9 (11-12) ◽  
pp. 775 ◽  
Author(s):  
Pejman Shadpour ◽  
H. Habib Akhyari ◽  
Robab Maghsoudi ◽  
Masoud Etemadian
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Left Kidney ◽  
Operation Time ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Referral Centre ◽  
Laparoscopic Management ◽  
The Mean ◽  
Crossing Vessels

Introduction: We report our experience with laparoscopic management of ureteropelvic junction obstruction in horseshoe kidneys.Methods: Between February 2004 and March 2014, 15 patients with horseshoe kidneys and symptomatic ureteropelvic junction obstruction underwent laparoscopic management at our national referral centre. Depending on the anatomy and presence of obtrusive vessels or isthmus, we performed either dismembered, Scardino or Foley YV pyeloplasty, or Hellstrom vessel transposition. Patients were initially evaluated by ultrasonography, then diuretic scintiscan at 4 to 6 months, and followed by yearly clinical and sonographic exams.Results: This study included 11 male and 4 female patients between the ages of 4 to 51 year (average 17.7). The left kidney was involved in 12 patients (80%). Operation time was 129 minutes (range: 90–186), and patients were discharged within 2.8 days (range: 1–6). Although 8 (53.3%) patients had crossing vessels, of which 6 required transposing, the Hellstrom technique was solely used in 3 cases, of which notably 1 case failed to resolve and required laparoscopic Hynes within the next year. Eight cases underwent dismembered pyeloplasty, 2 Foley YV, 1 Scardino flap and 1 required isthmectomy and vessel suspension. At the mean follow-up of 60 (range: 18–120) months, the overall success rate was 93.3%.Conclusions: To our knowledge, this represents the largest report on laparoscopic pyeloplasty for horseshoe kidneys, providing the longest follow-up. Our findings confirm prior reports supporting laparoscopy and furthermore show that despite the prevalence of crossing vessels, transposition alone is seldom sufficient.

scholarly journals Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

2016 ◽  
Vol 88 (3) ◽  
pp. 228 ◽  
Author(s):  
Faruk Ozgor ◽  
Abdulmuttalip Simsek ◽  
Ozgu Aydogdu ◽  
Onur Kucuktopcu ◽  
Omer Sarilar ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Tumor Size ◽  
Operation Time ◽  
Demographic Characteristics ◽  
Ischemia Time ◽  
Nephrometry Score ◽  
The Mean ◽  
Group 1

Objectives: To evaluate the possible role of an hemostatic matrix on hemostasis, perioperative outcomes and complications in patients who underwent laparoscopic partial nephrectomy (LPN). Materials and methods: Patients charts were analyzed retrospectively and their demographic characteristics, operative parameters and follow-up results were recorded. Patients were divided into two groups, according to those who used an hemostatic matrix as Group 1 (n = 41) and those who did not used as Group 2 (n = 44). Demographic characteristics of patients, tumor features, operation time, clamping of the renal vessels, ischemia time, suturing of the collecting system, perioperative hemorrhage and complications were evaluated. Histopathological results, surgical margin status, creatinine level and recurrence at the 3rd month of follow up were analyzed. Statistical analyses were performed with SPSS 17.0 and significance was set at p value of &lt; 0.05. Results: The mean RENAL nephrometry score was 5.9 ± 2.0 and the mean tumor size was 35 ± 12 mm. All patients had a single tumor and 44 of them had a tumor in the right kidney. The renal artery was clamped in 79 cases and the mean ischemia time was 20.1 ± 7 minutes. The mean tumor size and the mean RENAL nephrometry score was statistically higher in Group 1 (p: 0.016 and p &lt; 0.001, respectively). Pelvicaliceal repair was more common in Group 1 due to deeper extension of tumors in this group (p: 0.038). In Group 1, less hemorrhage and blood transfusion requirement, with shorter ischemia and operation time was detected. Conclusion: The outcomes of the recent study showed that adjunctive use of an hemostatic matrix improves hemostasis and decreases hemorrhagic complications during LPN. Further prospective studies are required to assess the potential role of an hemostatic matrix in LPN.

scholarly journals Turbinoplasty of hypertrophied inferior turbinate by diode laser

1970 ◽  
Vol 16 (1) ◽  
pp. 29-34
Author(s):  
Md Rojibul Hoque ◽  
Asaduzzaman Rasel ◽  
Md Khalid Asad ◽  
Moni Lal Aich
Keyword(s):  
Diode Laser ◽  
Local Anesthesia ◽  
Operation Time ◽  
Inferior Turbinate ◽  
Complete Relief ◽  
Clinical Experiences ◽  
Short Operation Time ◽  
The Mean ◽  
Conventional Radiology

Background: Different laser types have been used for the treatment of hypertrophied inferiornasal turbinates. The clinical experiences of its treatment by means of a diode laser are presented.Methods: A total of 45 patients suffering from nasal obstruction due to hypertrophied inferiorturbinates (HIT) were treated with a continuous diode laser (14 W- 940 nm) in "contact" modeand under local anesthesia. Thirty patients (16 with allergic rhinitis and 14 with vasomotorrhinitis) were included into this clinical trial with a follow-up of 6 months. The study wasconducted by a questionnaire, photo documentation, conventional radiology of the paranasalsinuses, and histology.Results: The mean operation time took 8 min/turbinate, no nasal packing was necessary andno immediate complications (e.g., bleeding) were observed. Statistical analysis revealedsignificant subjective improvement (86%) of the nasal airflow and nasal cavity volume (photodocumentation) 6 months after laser surgery. In addition, complete relief of headache wasachieved in 32%. The remission rates of persistent rhinorrhoea and post-nasal dripping were,at about 88% and 64%, respectively. Atrophic change and synechiae had not been observed.Conclusions: Diode laser treatment of HIT is a useful procedure, which can be performed as anoutpatient surgery under local anesthesia, resulting in a controlled coagulation and ablation of thesoft tissue. The short operation time and the good results provide an excellent patient acceptance.Key words: Diode Laser; Hypertrophied Inferior Turbinate; Turbinoplasty.DOI: 10.3329/bjo.v16i1.5778Bangladesh J Otorhinolaryngol 2010; 16(1): 29-34

scholarly journals Correction of Temporal Hollowing Deformity Using Serratus Anterior Muscle Flap

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Lan Sook Chang ◽  
Youn Hwan Kim ◽  
Sang Wha Kim
Keyword(s):  
Muscle Flap ◽  
Operation Time ◽  
Facial Asymmetry ◽  
Free Flaps ◽  
Frontal View ◽  
Serratus Anterior ◽  
Aesthetic Form ◽  
The Mean ◽  
Fascia Flap

Temporal hollowing deformity (THD) is a contour irregularity in the frontotemporal region, which results in facial asymmetry in the frontal view. Here, we present our clinical experience of correction of THD using serratus anterior (SA) muscle and fascia free flaps. Between March 2016 and December 2018, 13 patients presenting with THD were treated with SA free flap. The mean age of the patients was 47.8 years. The patients received craniectomy due to subarachnoid hemorrhage, epidural hematoma, or brain tumor. On average, correction of THD was performed 17 months after cranioplasty. The SA flap size ranged from 5 × 5   cm to 10 × 8   cm . The mean operation time was 107.3 minutes. All of the flaps survived without complications. The mean follow-up duration was 20.3 months. For correction of THD, the SA muscle and fascia flap is among the best candidates to permanently restore aesthetic form and symmetry.

Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

2020 ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background Surgical management of lumbar disc herniation in the hidden zone is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce a safe and effective technique named microscopic extra-laminar sequestrectomy (MELS) for treatment of hidden zone lumbar disc herniation and present clinical outcomes within a two year follow-up period. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with hidden zone lumbar disc herniation were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and herniated fragment were visually exposed using this extra-laminar approach. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 months, ranging from 18 to 24 months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is a safe and effective method in the management of hidden zone lumbar disc herniation. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

MULTIPLE SIMULTANEOUS APPROACH IN LOWER EXTREMITY SPASTICITY SURGERY

2000 ◽  
Vol 04 (03) ◽  
pp. 221-229
Author(s):  
Ugur Sayli ◽  
Sinan Avci
Keyword(s):  
Lower Extremity ◽  
Orthopedic Surgery ◽  
Daily Living ◽  
Operation Time ◽  
Postoperative Rehabilitation ◽  
Horse Riding ◽  
Simultaneous Surgery ◽  
The Mean ◽  
Different Levels

Lower extremity spasticity in CP interferes with daily living activities, such as ambulation and sitting as well as hygiene. Orthopedic surgery may be needed in the prevention and correction of the deformities and malalignments. Seven girls and nine boys with ages ranging from 7 to 17 years who had at least four surgeries at different levels of their lower extremities in a single stage were presented. Minimum follow-up was two years. The mean number of surgeries performed simultaneously was 6 (4 to 11). The mean operation time was 115 minutes (35 to 225 minutes) and the mean blood loss was 200 ml (100 to 600 ml) during surgery. The hospital stay ranged from two to six days. No complication which may be related to multiple simultaneous surgery was observed. Rehabilitation was begun as soon as the pain permitted. In the postoperative period, the diplegics attended sessions of hippotherapy — therapy by horse riding — in addition to formal therapy modalities. At the latest follow-up postoperatively, all the patients had increase in their level of activities. As a conclusion, whenever needed, simultaneous correction of the lower extremity deformities in spastic CP patients decreases costs and simplifies postoperative rehabilitation without increasing surgical risk for the patients.

Carpal Tunnel Release Using a Short Palmar Incision and a New Knife

2000 ◽  
Vol 25 (4) ◽  
pp. 357-360 ◽  
Author(s):  
S. AVCI ◽  
U. SAYLI
Keyword(s):  
Light Source ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Carpal Tunnel Release ◽  
Self Care ◽  
Operation Time ◽  
Major Complications ◽  
Flexor Retinaculum ◽  
The Mean

A new knife with its own battery powered light source (Knifelight®, Stryker Instruments, Kalamazoo, Michigan, USA) was used for carpal tunnel release in 31 wrists of 25 patients. Under local anaesthesia, a short palmar incision was used and the carpal tunnel contents were visualized during division of the flexor retinaculum. The mean operation time was 11 minutes and no major complications were seen. The patients could use their hands for self-care after 3 days and returned to work at a mean of 23 days. At a minimum follow-up of 6 months, all but one of the patients were satisfied with the final result. Mild scar tenderness was seen in two patients and pillar pain in one patient.

scholarly journals Lumbar and para-iliac hernias: an alternative technique

2021 ◽  
Vol 48 ◽  
Author(s):  
MARIA PESSOLE BIONDO SIMÕES ◽  
ALEXANDRE CONTIN MANSUR ◽  
SILVANIA KLUG PIMENTEL
Keyword(s):  
Bone Graft ◽  
Blunt Trauma ◽  
Iliac Crest ◽  
Aortic Surgery ◽  
Iliac Bone ◽  
Lumbar Region ◽  
Alternative Technique ◽  
Iliac Bone Graft ◽  
The Mean

ABSTRACT Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the abdomen. The incidence of hernia after the removal of these grafts ranges from 0.5 to 10%. These hernias are a problem that surgeons will face, since bone grafts from the iliac crest are being used more routinely. The goal of this article was to report the technique to correct these complex hernias, using the technique of fixing the propylene mesh to the iliac bone and the result of this approach. In the period of 5 years, 165 patients were treated at the complex hernia service, 10 (6%) with hernia in the supra-iliac and lumbar region, managed with the technique of fixing the mesh to the iliac bone with correction of the failure. During the mean follow-up of 33 months (minimum of 2 and maximum of 48 months), there was no recurrence of the hernias.

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