scholarly journals Physical Therapy for the Horizontal Semicircular Cupulolithiasis: A Prospective Interventional Case Series from an Otoneurology Center in South Rajasthan, India

2021 ◽  
Author(s):  
Ajay Kumar Vats ◽  
Jugal Kishor Sharma ◽  
G. D. Ramchandani
Keyword(s):  
Physical Therapy ◽  
Treatment Options ◽  
Case Series ◽  
Positional Nystagmus ◽  
Interventional Study ◽  
Short Term ◽  
Physical Therapies ◽  
Established Treatment

Abstract Objective This article aims to study the effect of physical therapy in patients of horizontal semicircular cupulolithiasis with results audited in the short term. Design Nonrandomized prospective interventional study. Study Sample Four patients with horizontal semicircular cupulolithiasis. Results All four patients in whom diagnostic supine roll test (carried at least thrice to look for the sustainability as well as the polarity of the nystagmus) elicited apogeotropic horizontal positional nystagmus lasting more than 1 minute were subjected to therapeutic head-shaking maneuver (HSM). The results were audited immediately after the physical therapy, and at 1 hour. Follow-up by telephonic interviews for 4 weeks was done in all patients. Three out of four patients responded to HSM alone. One patient who did not respond to HSM was successfully treated with four other sequent physical therapies. Conclusion The response of physical therapy for horizontal semicircular cupulolithiasis occasionally indicates the side of the cupula to which otoconial debris is adherent (Cup-U or Cup-C). Occasionally, Cup-C variant of horizontal semicircular cupulolithiasis can be transformed by physical therapy to long posterior arm horizontal semicircular canalolithiasis—a disorder with better established treatment options.

Midcarpal instability

2015 ◽  
Vol 41 (1) ◽  
pp. 86-93 ◽  
Author(s):  
D. G. Hargreaves
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Case Series ◽  
Definite Diagnosis ◽  
Stress Tests ◽  
Functional Instability ◽  
Painful Wrist ◽  
Relative Rarity ◽  
Passive Stress

Midcarpal instability is a collective term for a number of conditions where the instability of the wrist is predominantly between the proximal and distal carpal rows. It has been regarded as relatively rare and infrequently requires surgical treatment. Palmar midcarpal instability is the most commonly found type of midcarpal instability and can be responsible for causing a clunking and painful wrist. The diagnosis is made on clinical grounds using the midcarpal instability provocative tests. Standard imaging and arthroscopic inspection do not usually confirm a definite diagnosis, but are important in excluding other pathologies. The classification and staging has been described using the extent of palmar translocation of the distal carpal row, which is elicited on passive stress tests. As this is a functional instability, it may be that a functional staging description might be better, and a proposed scheme is described. Treatment options including partial wrist fusions, tenodesis stabilizations and arthroscopic capsular shrinkage have been described in small case series with limited follow-up. There are no comparative series or randomized studies because of the relative rarity of this condition.

scholarly journals Tibial Plateau Leveling Following Tibial Tuberosity Advancement: A Case Series

2022 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Daniele Serrani ◽  
Pierre Paul Picavet ◽  
Juan Marti ◽  
Bernard Bouvy ◽  
Marc Balligand ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Case Series ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Short Term ◽  
Long Term Follow Up ◽  
Persistent Instability

Persistent stifle instability is a recognized complication following tibial tuberosity advancement techniques (TTAT). The aim of this study is to report the feasibility and outcome of tibial plateau leveling techniques (TPLT) to treat dogs with persistent lameness, suspected to be secondary to persistent stifle instability, following (TTAT). Medical records of dogs presented for persistent lameness after TTAT were reviewed. Preoperative data included orthopedic examination, lameness score and radiographs. Inclusion criteria included performance of a surgery to address persistent lameness and suspected instability. Short-term follow up data included orthopedic examination and radiographs of the stifle. Long-term follow up was based on postoperative Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Seven dogs were included in the study. Mean subjective preoperative lameness score was 3 ± 1.53. Mean preoperative patellar ligament angle relative to the tibial plateau (PLATP) was 94° and mean tibial plateau angle (TPA) was 28°. Six dogs had tibial plateau leveling osteotomy and one had modified cranial closing wedge ostectomy. Mean postoperative PLATP was 79° and mean TPA was 5°. Mean subjective lameness score at follow up was 0.57 ± 0.49. Minor complications were present in 2 dogs and major complication in 1 dog. Mean LOAD questionnaire score was 6.6/52. TPLT can be performed after TTAT and may improve clinical function and stability in these cases in which persistent instability is suspected.

Doxycycline Injection Treatment for Unicameral Bone Cysts: a Case Series

2021 ◽  
Author(s):  
Andrew Albert ◽  
Monte Squiers ◽  
Eric E. Poole ◽  
Bennett W. Hartley ◽  
Maxwell V. Phillips ◽  
...  
Keyword(s):  
Side Effects ◽  
Matrix Metalloproteinases ◽  
Case Series ◽  
Pathologic Fracture ◽  
Bone Cysts ◽  
Short Term ◽  
Symptom Resolution ◽  
Osteoclast Activity ◽  
Injection Treatment

Abstract Background: Unicameral bone cysts (UBCs) are frequently associated with pathologic fracture due to aggressive osteolysis. Methods/Results: We present a case series (n=5) with complex or refractory bone cysts treated with doxycycline injections that exhibited increased ossification and symptom resolution at short term follow up with minimal side effects. Conclusions: In addition to its antibiotic properties, doxycycline is also known to inhibit matrix metalloproteinases, angiogenesis, and osteoclast activity suggesting that UBCs are dependent on MMP, VEGF or RANKL-mediated osteolysis. Further investigation is warranted regarding the use of doxycycline injections in UBCs.

scholarly journals A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy

2016 ◽  
Vol 40 (6) ◽  
pp. E7 ◽  
Author(s):  
Syed F. Abbas ◽  
Morgan P. Spurgas ◽  
Benjamin S. Szewczyk ◽  
Benjamin Yim ◽  
Ashar Ata ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Neck Disability Index ◽  
Case Series ◽  
Patient Characteristics ◽  
Short Term ◽  
Instrumented Fusion ◽  
Minimally Invasive Surgical ◽  
Neck Disability

OBJECTIVE Minimally invasive posterior cervical decompression (miPCD) has been described in several case series with promising preliminary results. The object of the current study was to compare the clinical outcomes between patients undergoing miPCD with anterior cervical discectomy and instrumented fusion (ACDFi). METHODS A retrospective study of 74 patients undergoing surgery (45 using miPCD and 29 using ACDFi) for myelopathy was performed. Outcomes were categorized into short-term, intermediate, and long-term follow-up, corresponding to averages of 1.7, 7.7, and 30.9 months, respectively. Mean scores for the Neck Disability Index (NDI), neck visual analog scale (VAS) score, SF-12 Physical Component Summary (PCS), and SF-12 Mental Component Summary (MCS) were compared for each follow-up period. The percentage of patients meeting substantial clinical benefit (SCB) was also compared for each outcome measure. RESULTS Baseline patient characteristics were well-matched, with the exception that patients undergoing miPCD were older (mean age 57.6 ± 10.0 years [miPCD] vs 51.1 ± 9.2 years [ACDFi]; p = 0.006) and underwent surgery at more levels (mean 2.8 ± 0.9 levels [miPCD] vs 1.5 ± 0.7 levels [ACDFi]; p < 0.0001) while the ACDFi patients reported higher preoperative neck VAS scores (mean 3.8 ± 3.0 [miPCD] vs 5.4 ± 2.6 [ACDFi]; p = 0.047). The mean PCS, NDI, neck VAS, and MCS scores were not significantly different with the exception of the MCS score at the short-term follow-up period (mean 46.8 ± 10.6 [miPCD] vs 41.3 ± 10.7 [ACDFi]; p = 0.033). The percentage of patients reporting SCB based on thresholds derived for PCS, NDI, neck VAS, and MCS scores were not significantly different, with the exception of the PCS score at the intermediate follow-up period (52% [miPCD] vs 80% [ACDFi]; p = 0.011). CONCLUSIONS The current report suggests that the optimal surgical strategy in patients requiring dorsal surgery may be enhanced by the adoption of a minimally invasive surgical approach that appears to result in similar clinical outcomes when compared with a well-accepted strategy of ventral decompression and instrumented fusion. The current results suggest that future comparative effectiveness studies are warranted as the miPCD technique avoids instrumented fusion.

Early Outcomes of 3D Printed Total Talus Arthroplasty

2019 ◽  
Vol 13 (5) ◽  
pp. 372-377 ◽  
Author(s):  
Daniel J. Scott ◽  
John Steele ◽  
Amanda Fletcher ◽  
Selene G. Parekh
Keyword(s):  
Treatment Option ◽  
Treatment Options ◽  
Case Series ◽  
Level Of Evidence ◽  
Ankle Motion ◽  
Motion Data ◽  
Number Of Patients ◽  
3D Printed ◽  
Radiographic Alignment

Background. Patients with talar avascular necrosis (AVN) have limited treatment options to manage their symptoms. Historically, surgical options have been limited and can leave patients with little ankle motion and have high failure rates. The use of custom 3D printed total talar replacements (TTRs) has arisen as a treatment option for these patients, possibly allowing better preservation of hindfoot motion. We hypothesized that patients undergoing TTR will demonstrate a statistically significant improvement in Foot and Ankle Outcome Score (FAOS) at 1 year after surgery. Methods. We retrospectively reviewed 15 patients who underwent a TTR over a 2-year period. Patient outcomes were reviewed, including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, radiographic alignment, FAOS and Visual Analog Scale (VAS) score, and range of motion. Data analysis was performed with Student t-tests and multivariate regression. Results. FAOSs and VAS scores showed statistically significant improvements postoperatively as compared with preoperative scores. There was a statistically significant decrease in VAS pain scores from 7.0 preoperatively to 3.6 (P < .001). Average follow-up was 12.8 months. With the number of patients available, there was no statistically significant change in radiographic alignment parameters postoperatively as compared with preoperatively (P values ranged from .225 to .617). Conclusion. Our hypothesis that these patients show statistically significant improvements in FAOSs at 1 year was confirmed. TTR represents an exciting treatment option for patients with talar AVN, though longer-term follow-up is needed. Level of Evidence: Level IV: Case series

scholarly journals The Necessity of Chest Physical Therapy for Thoracoscopic Oesophagectomy

2005 ◽  
Vol 33 (4) ◽  
pp. 434-442 ◽  
Author(s):  
T Nakatsuchi ◽  
M Otani ◽  
H Osugi ◽  
Y Ito ◽  
T Koike
Keyword(s):  
Physical Therapy ◽  
Respiratory Function ◽  
Radical Surgery ◽  
Thoracoscopic Surgery ◽  
Respiratory Complications ◽  
Short Term ◽  
Less Invasive ◽  
Before And After ◽  
Chest Physical Therapy

Radical surgery for thoracic oesophageal cancer is highly invasive and often leads to respiratory complications; thoracoscopic surgery is a less-invasive alternative. We examined the need for chest physical therapy (CPT) after thoracoscopic oesophagectomy. Thirty-six consecutive patients, randomly selected for either thoracotomy or thoracoscopic surgery, were included in a randomized clinical trial and received CPT under the same protocol. During short-term post-operative follow-up, both groups showed a marked reduction in respiratory function and responded to CPT to the same extent, although 2 weeks after surgery some parameters of respiratory function were significantly higher in the thoracoscopy group. Thoracoscopic surgery has been reported to be less invasive than standard thoracotomy, but our results suggest that the procedure is also invasive with respect to respiratory function and that CPT should be performed before and after thoracoscopic surgery.

Short-Term Results of Endoscopic Percutaneous Longitudinal Tenotomy for Noninsertional Achilles Tendinopathy and the Presentation of a Simplified Operative Method

2018 ◽  
Vol 12 (1) ◽  
pp. 73-78
Author(s):  
Michel Chraim ◽  
Hamza M. Alrabai ◽  
Sabine Krenn ◽  
Peter Bock ◽  
Hans-Jörg Trnka
Keyword(s):  
Achilles Tendon ◽  
Carpal Tunnel Release ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Operation Technique ◽  
Outpatient Basis ◽  
Short Term ◽  
Pain Visual Analog Scale ◽  
Postoperative Thrombosis

Purpose: This study was aimed to review the short-term results of endoscopic percutaneous longitudinal tenotomy for noninsertional Achilles tendinopathy using the Centerline Endoscopic Carpal Tunnel Release instrument (Arthrex). This method simplifies the operation technique, allows a good endoscopic visualisation of the Achilles tendon with very promising results. Methods: We performed multiple percutaneous longitudinal tenotomies under local anesthesia in 24 patients (25 tendons) with Achilles tendinopathy or peritendinitis that had failed conservative treatment between January 2013 and September 2016. All ambulatory procedures consisted of paratenon release and longitudinal tenotomies. The results were reviewed in 22 patients (23 tendons) at an average follow-up period of 22.5 months (range 10-36 months). Patients’ satisfaction and functional outcomes were evaluated using the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire, the pain visual analog scale (VAS), and the functional foot index. Results: Initial results are very promising with excellent results in 12 patients, good results in 9 patients, and fair result in 1 patient. One patient developed a postoperative thrombosis of the operated limb. Another patient developed a hypertrophic painful scar of the incision wound. The VAS for pain decreased drastically after the index procedure and averaged to 0.2 (SD 0.447). The VISA-A questionnaire score had improved from 42 ± 7.2 points preoperatively to 96.8 ± 14.3 points postoperatively (P = .004). The functional foot index decreased from 84 (SD 30.517) to 33.4 (SD 6.452) on the follow-up examination. Conclusions: The endoscopic-assisted longitudinal tenotomies procedure of the Achilles tendon is easily feasible and can be performed on an outpatient basis, produces minimal complications and shows excellent results. The described technique is recommended for all surgeons especially for those familiar with endoscopy of the Achilles tendon. Levels of Evidence: Therapeutic, Level IV: Case Series

scholarly journals A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Vivek Verma ◽  
Matthew Roman ◽  
Disha Shah ◽  
Marina Zaretskaya ◽  
Mohamed H. Yassin
Keyword(s):  
White Matter ◽  
Short Term Memory ◽  
Treatment Options ◽  
Chronic Fatigue ◽  
Short Term ◽  
Mri Findings ◽  
White Matter Changes ◽  
Neurological Improvement ◽  
Magnetic Resonance Imaging Mri

A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.

scholarly journals Efficacy of intratympanic injection of dexamethasone in the treatment of subjective idiopathic tinnitus

2019 ◽  
Vol 5 (4) ◽  
pp. 1056
Author(s):  
Sandeep Shetty ◽  
Ammu George ◽  
Shilpa Chandrashekar ◽  
Bhadravathi Ganesh Prakash
Keyword(s):  
Tympanic Membrane ◽  
Spinal Needle ◽  
Topical Anaesthesia ◽  
Interventional Study ◽  
Short Term ◽  
Improvement Rate ◽  
Medical College ◽  
Intratympanic Injection ◽  
Inferior Quadrant

<p class="abstract"><strong>Background:</strong> To study the efficacy of intratympanic injection of dexamethasone in cases of subjective idiopathic tinnitus.</p><p class="abstract"><strong>Methods:</strong> Prospective interventional study at the Department of ENT, JSS Medical College and Hospital, Mysore, in which 45 patients diagnosed clinically as subjective idiopathic tinnitus, for a duration of 2 years from October 2016 were included in the study. The patients were subjected to 3 intratympanic injections of dexamethasone once in a week for 3 weeks.  They received a 0.5 ml intratympanic injection of 4mg/ml dexamethasone solution. After topical anaesthesia, using a 2 ml syringe and a spinal needle no. 22, the assigned solution was administered under direct vision using an endoscope in the postero- inferior quadrant of the tympanic membrane. They were followed up at the end of 1 and 3 months from the last injection. Tinnitus handicap inventory was repeated during the follow up and was compared to the value at presentation.  </p><p class="abstract"><strong>Results:</strong> There was a statistically significant improvement in the THI at the first follow up compared with the baseline THI. Whereas there was no statistically significant change in improvement rate from the 1st follow up to the 2nd follow up (p=0.7), however there is decrease in the improvement, which means the improvement is temporary, and starts reverting by the second visit to some extent.</p><p class="abstract"><strong>Conclusions:</strong> It was observed that the improvement in the tinnitus was for a short term after intratympanic injection of dexamethasone.</p>

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