Long-term results with hydroxylapatite middle ear implants

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympanomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

Download Full-text

Long-term Results with Hydroxylapatite Middle Ear Implants

Otolaryngology ◽

10.1016/s0194-5998(00)70188-4 ◽

2000 ◽

Vol 122 (5) ◽

pp. 635-642 ◽

Cited By ~ 39

Author(s):

Robert A. Goldenberg ◽

Mark Driver

Keyword(s):

Long Term Results ◽

Hearing Results ◽

Factors Associated ◽

Hearing Result ◽

Middle Ear Implants ◽

Long Term Follow Up ◽

The Mean ◽

Canal Wall Up

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympa-nomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

Download Full-text

Crescentic Proximal Metatarsal Osteotomy for Moderate to Severe Hallux Valgus: A Mean 12.2 Year Follow-Up Study

Foot & Ankle International ◽

10.1177/107110070102201007 ◽

2001 ◽

Vol 22 (10) ◽

pp. 817-822 ◽

Cited By ~ 105

Author(s):

J.P. Veri ◽

S.P. Pirani ◽

R. Claridge

Keyword(s):

Hallux Valgus ◽

Long Term Results ◽

Soft Tissue Reconstruction ◽

Short Term ◽

Long Term Follow Up ◽

Short And Long Term ◽

The Mean ◽

Severe Hallux Valgus

The senior author's (R.C.) first 25 patients (37 feet) treated with a combination proximal crescentic osteotomy and distal soft-tissue reconstruction made up the patient cohort. All 25 patients were reviewed at a minimum of one year post-op (short-term follow-up) and 20/25 (31/37 feet) were reviewed again at a mean 12.2 years (range 11.4 to 13.0 yrs) post-op (long-term follow-up). This allowed for a comparison of short- and long-term results and led to a long-term follow-up rate of 84% (31/37 feet, mean 12.2 yrs). Clinical, radiographic and patient outcome measures were obtained and compared pre-op and at short- and long-term follow-up. The mean preoperative hallux valgus (HVA) and intermetatarsal angles (IMA) were 37° and 16° respectively. The mean HVA correction was 24° and IMA correction 10° at long-term follow-up with no tendency toward recurrence. Sesamoid position and first MTP subluxation was markedly improved postoperatively and the correction was maintained at long-term follow-up. Patients were asked about their satisfaction in terms of pain, appearance and motion. At long-term follow-up, more than 90% of patients were completely satisfied with pain and motion and greater than 80% with their appearance. Ninety-four percent of patients said they would have the operation again. The AOFAS clinical rating scale for the hallux was calculated retrospectively for pre-op and short-term follow-up and prospectively for long-term follow-up. The mean pre-op score was 37/100 (16 to 60) which significantly improved to 92/100 (67 to 100) at both follow-up periods, suggesting no evidence of decrease in outcome over time. Complications included two patients (5%) that were over-corrected into varus (one symptomatic, one asymptomatic), and four patients (11%) that were undercorrected, developing asymptomatic recurrences (>10° increase HVA) at long-term follow-up. In addition, two patients (5%) developed new transfer lesions postoperatively, likely related to technical error (one varus overcorrection, one dorsiflexion malunion). In conclusion, the long-term results, with a mean follow-up of 12.2 years, of the resection realignment procedure for moderate to severe hallux valgus are generally excellent and the complication rate is low and acceptable. Attention to detail, avoiding both undercorrection, which can lead to recurrence, and overcorrection, which can cause symptomatic varus, is essential.

Download Full-text

Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00203 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0020

Author(s):

Kemal Gökkuş ◽

Ahmet Turan Aydın

Keyword(s):

Clinical Results ◽

Long Term Results ◽

Long Distance ◽

Aofas Score ◽

Pes Cavus ◽

Duration Of Symptoms ◽

Long Term Follow Up ◽

The Mean

Objectives: The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients. Methods: 56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidrilling /microfracture between the period of 2005-2010 were evaluated. Arthroscopy performed through the standart portals with knee arthroscopy instruments. The instruments that used for multİdrilling and microfracture were custom maded. The clinical results were evaluated in retrospective manner with face to face and telephone interview.The AOFAS questionary and satisfaction question (subjective ) were asked on patients. Results: The female / male ratio was 29/27. The mean age was 40.5 (Min. 17- Max.70), the mean follow period was 5.9 year. (Min. 4 year – Max. 8 year).The distrubition of stages on our group were , seven patients were stage I , five patients were stage II , twenty one patients were stage III , eight patients were stage IV , fifteen patient were stage V. The lateral location exists on 7 patients, the medial location exists on 49 patients. 40 patients had middle lesion and other 9 patients had posterior lesions. The clinical results were: the mean preoperative AOFAS score was 46.1 (Min. 34- Max.. 65), the mean post operative AOFAS score was 90.8 (Min. 41- Max. 100). The unsatisfactory results were taken from 2 patients. The moderate satisfaction results were taken from 5 patients . The most frequent trauma mechanism were ankle sprain . The duration of symptoms before admitting to our clinic was maximum 10 years and the minimum 2 months. The mean value was 22.7 months. Conclusion: The coexistence of other pathologies were local synovitis, pes cavus and pes planovalgus, degenerative arthritis (mild) , bone marrow edema, posterior talar process fracture and hallux valgus respectively. Duration of period before admitting to our clinic and being classified as higher stages detected as most important factors that negatively effects the results. The unsatisfied patients (2 patients ) had also coexisting with loose bodies and pes cavus at the same time. In Stage 5 group the postoperative AOFAS increase an average of 41, while in patients with lower than stage 5 the mean increase was 48. The older age was not significant negative factor on results. Our long term results of arthroscopic debridement, curettage and multidrilling /microfracture were succcesfull at the rate of %88; while the unsuccesfull at 2 (%3) patients (unsatisfied and post- operative AOFAS score was 41 and 56), 5 patients (%9) had moderate satisfaction (pain with long standing and disability in long distance walking and AOFAS scores were between 72-80 ).

Download Full-text

Long-term results of revision stapes surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215100121498 ◽

1992 ◽

Vol 106 (11) ◽

pp. 971-973 ◽

Cited By ~ 11

Author(s):

Eero Vartiainen ◽

Juhani Nuutinen ◽

Jukka Virtaniemi

Keyword(s):

Revision Surgery ◽

Oval Window ◽

Stapes Surgery ◽

Long Term Results ◽

Surgical Trauma ◽

Hearing Results ◽

The Mean ◽

Revision Stapes Surgery

AbstractResults of 45 re-operations for persistent or recurrent conductive deafness after primary stapes surgery were studied. The mean follow-up period after the revision surgery was 7.6 years. Long-term hearing results were found to be disappointing, air-bone gap to within 10 dB was achieved in only 46 per cent of the patients. Mean hearing levels improved by 11 dB or more in 73 per cent. Outcome of surgery was dependent on the surgical pathology, the best hearing results were obtained in cases with re-fixation after stapes mobilization operation. Sensorineural hearing loss as a result of surgical trauma to the inner ear occurred in revision surgery more frequently than in primary operations, cases with regrowth of otosclerotic bone to the oval window after stapedectomy having the greatest risk of labyrinthine trauma.

Download Full-text

Results of Long-Term Follow-Up after Compensated Fixed-Dose Therapy for Thyrotoxicosis

Journal of International Medical Research ◽

10.1177/030006059202000310 ◽

1992 ◽

Vol 20 (3) ◽

pp. 279-288 ◽

Cited By ~ 3

Author(s):

A Zaini ◽

A Khir ◽

S AR Doi ◽

S P Chan ◽

M Paramsothy ◽

...

Keyword(s):

Single Dose ◽

Antithyroid Drug ◽

Long Term Results ◽

Fixed Dose ◽

Antithyroid Drug Therapy ◽

Long Term Follow Up ◽

Iodine 131 ◽

The Mean

To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (± SD) duration of follow-up was 74.5 ± 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.

Download Full-text

Short- and Long-Term Results of Stapedotomy and Stapedectomy with a Teflon-Wire Piston Prosthesis

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940111001003 ◽

2001 ◽

Vol 110 (10) ◽

pp. 907-911 ◽

Cited By ~ 34

Author(s):

Maria Izabel Kos ◽

Pierre B. Montandon ◽

Jean-Philippe Guyot

Keyword(s):

Hearing Loss ◽

Postoperative Complications ◽

Evaluation Criteria ◽

Long Term Results ◽

Hearing Results ◽

Long Term Follow Up ◽

Short And Long Term ◽

Residual Air

We analyzed the results of 604 cases of primary stapes surgery performed between 1974 and 1997 with replacement of the stapes by a 0.6- or 0.8-mm Schuknecht Teflon-wire piston. At long-term follow-up (1 to 21 years; mean, 7 years), the residual air-bone gap was 10 dB or less in 79% of the cases. The hearing results and postoperative complications were comparable to those reported by authors who used the same evaluation criteria. Although the aim of the surgery was to perform a small stapedotomy with a narrow footplate perforation (0.8 mm), a large stapedotomy or a stapedectomy was performed in 134 cases (22.2%) because of surgical or anatomic conditions. Our results show that the larger footplate perforations allowed a better correction of the air-bone gap at the lower frequencies. The ears with larger perforations did not show a higher incidence of sensorineural hearing loss.

Download Full-text

Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral Arteries

Journal of Endovascular Therapy ◽

10.1177/152660289600300403 ◽

1996 ◽

Vol 3 (4) ◽

pp. 369-379 ◽

Cited By ~ 6

Author(s):

Michel Henry ◽

Max Amor ◽

Rafael Beyar ◽

Isabelle Henry ◽

Jean-Marc Porte ◽

...

Keyword(s):

Long Term Results ◽

Lesion Length ◽

Secondary Patency ◽

Peripheral Arteries ◽

External Compression ◽

Nitinol Stent ◽

Nitinol Stents ◽

The Mean

Purpose: To evaluate a new self-expanding nitinol coil stent in stenotic or occluded peripheral arteries. Methods: Seventy-three symptomatic patients (58 men; mean age 67 years) were treated with nitinol stents for lesions in the iliac artery (9 stenoses); superficial femoral artery (SFA) (39 stenoses, 6 occlusions); popliteal artery and tibioperoneal trunk (9 stenoses, 7 occlusions); and 3 bypass grafts. Mean diameter stenosis was 84.4% ± 9.9% (range 75% to 100%), and mean lesion length was 45 ± 23 mm (range 20 to 120 mm). Results: Eighty-eight 40-mm-long stents with diameters between 5 and 8 mm were implanted percutaneously for suboptimal dilation (n = 45); dissection (n = 21); and restenosis (n = 7). All stents but one were implanted successfully; the malpositioned stent was removed, and another stent was successfully deployed. There were 3 (4.1%) failures due to thrombosis at 24 hours. During the mean 16-month follow-up (range to 44 months), 4 restenoses (3 femoral, 1 popliteal) have occurred; 2 were treated with repeat dilation and 2 underwent bypass. Primary and secondary patency rates at 18 months were 87% and 90%, respectively, for all lesions (iliac: 100% for both; femoral: 85% and 88%; popliteal: 87% and 100%). Conclusions: This new nitinol stent seems to be safe and effective with favorable long-term results, even in distal SFA lesions and popliteal arteries. Its flexibility and resistance to external compression allow its placement in tortuous arteries and near joints.

Download Full-text

Endovascular Treatment of Anterior Circulation Aneurysms With the p64 Flow Modulation Device: Mid- and Long-Term Results in 617 Aneurysms From a Single Center

Operative Neurosurgery ◽

10.1093/ons/opaa425 ◽

2021 ◽

Author(s):

Marta Aguilar Pérez ◽

Elina Henkes ◽

Victoria Hellstern ◽

Carmen Serna Candel ◽

Christina Wendl ◽

...

Keyword(s):

Intracranial Aneurysms ◽

High Rate ◽

Long Term Results ◽

Effective Treatment Option ◽

Anterior Circulation ◽

Acute Hemorrhage ◽

Unruptured Aneurysms ◽

Long Term Follow Up

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.

Download Full-text

Surgical treatment of pulmonary artery sarcoma: a report of 17 cases

Pulmonary Circulation ◽

10.1177/2045894020986394 ◽

2021 ◽

Vol 11 (1) ◽

pp. 204589402098639

Author(s):

Wu Song ◽

Long Deng ◽

Jiade Zhu ◽

Shanshan Zheng ◽

Haiping Wang ◽

...

Keyword(s):

Pulmonary Artery ◽

Survival Rates ◽

Tumor Resection ◽

Long Term Results ◽

Pulmonary Endarterectomy ◽

Pulmonary Artery Sarcoma ◽

The Mean ◽

Operative Findings

Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis is often delayed, and optimal treatment remains unclear. The aim of this study is to report our experience in the surgical management of this disease. Between 2000 and 2018, 17 patients underwent operations for PAS at our center. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, the postoperative outcomes, and the long-term results. The mean age at operation was 46.0 ± 12.4 years (range, 26–79 years), and eight (47.1%) patients were male. Six patients underwent tumor resection alone, whereas the other 11 patients received pulmonary endarterectomy (PEA). There were two perioperative deaths. Follow-up was completed for all patients with a mean duration of 23.5 ± 17.6 months (1–52 months). For all 17 patients, the median postoperative survival was 36 months, and estimated cumulative survival rates at 1, 2, 3, and 4 years were 60.0%, 51.4%, 42.9%, and 21.4%, respectively. The mean survival was 37.0 months after PEA and 14.6 months after tumor resection only ( p = 0.046). Patients who had no pulmonary hypertension (PH) postoperatively were associated with improved median survival (48 vs. 5 months, p = 0.023). In conclusion, PAS is often mistaken for chronic pulmonary thromboembolism. The prognosis of this very infrequent disease remains poor. Early detection is essential for prompt and best surgical approach, superior to tumor resection alone, and PEA surgery with PH relieved can provide better chance of survival.

Download Full-text