Can Posterior Reduction Replace Odontoidectomy as Treatment for Patients With Congenital Posterior Atlantoaxial Dislocation and Basilar Invagination?

2019 ◽  
Vol 18 (6) ◽  
pp. 660-667 ◽  
Author(s):  
Huai-yu Tong ◽  
Guang-yu Qiao ◽  
Bo Zhao ◽  
Yi-heng Yin ◽  
Teng Li ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Odontoid Process ◽  
Vertical Direction ◽  
Basilar Invagination ◽  
Imaging Data ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Actual Degree ◽  
The Difference

Abstract BACKGROUND For patients with odontoid process protrusion and basilar invagination, posterior screw–rod fixation can usually achieve satisfactory horizontal reduction, but in some cases satisfactory reduction in the vertical direction cannot be achieved at the same time. OBJECTIVE To propose a method for calculation of the theoretical maximum vertical reduction possible in individual patients. METHODS The computed tomography imaging data of patients with occipitalization and basilar invagination who were treated at our institute between January 2013 and June 2016 were retrospectively analyzed. The direction of odontoid reduction was decided by the inclination of the lateral joint. The atlanto-dental distance was assumed to be the maximum possible reduction in the horizontal direction. The maximum vertical reduction possible was calculated based on these values. RESULTS A total of 82 patients (34 males and 48 females) were included. The theoretical vertical reduction value was 4.2 ± 3.0 mm, which was significantly smaller than that of the dental protrusion (14.5 ± 3.8 mm, P = .000). Analysis of follow-up data (29 cases) showed that, the difference between the theoretical vertical reduction value H (4.7 ± 3.5 mm) and the actual vertical reduction value Ha (5.6 ± 3.5 mm) was not significant (P = .139). CONCLUSION The theoretical calculation method we proposed can well predict the actual degree of vertical reduction. The theoretical vertical reduction value is significantly lower than the odontoid protrusion value, indicating that satisfactory reduction in the vertical direction is difficult with a posterior approach alone.

scholarly journals A Case of Pyriform Sinus Fistula with Respiratory Distress in the Neonatal Period

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Noriko Hamaguchi ◽  
Hajime Ishinaga ◽  
Kazuki Chiyonobu ◽  
Hiroyuki Morishita ◽  
Kazuhiko Takeuchi
Keyword(s):  
Respiratory Distress ◽  
Neonatal Period ◽  
Fistulous Tract ◽  
Pyriform Sinus ◽  
Computed Tomography Imaging ◽  
Pharyngeal Wall ◽  
Tomography Imaging ◽  
Pyriform Sinus Fistula ◽  
Branchial Cleft

Pyriform sinus fistula (PSF) is an anomaly that can arise due to failure of involution of the third or fourth branchial cleft during embryogenesis. It can manifest clinically as sinuses, cysts, or abscesses in the neck and is common in childhood. Herein, we describe a neonate who presented with neck swelling and respiratory distress, which was secondary to a fourth branchial pouch sinus. Physical examination revealed swollen areas in the posterolateral pharyngeal wall and on the external left side of the neck. Computed tomography imaging showed a left-sided mass that was filled with air and fluid. Eventually, the pyriform sinus cyst and the entire fistulous tract were excised. The postoperative course was uneventful. Follow-up after 18 months showed no recurrence.

scholarly journals Veleszületett szemhéjcsüngés műtéti megoldása a szemhéjemelő izom kötőhártya felőli redőzésével

2021 ◽  
Vol 162 (18) ◽  
pp. 705-711
Author(s):  
Zsuzsanna Antus ◽  
Olga Lukáts ◽  
Irén Szalai ◽  
Zoltán Zsolt Nagy ◽  
Nóra Szentmáry
Keyword(s):  
Success Rate ◽  
Posterior Approach ◽  
Treatment Method ◽  
Inclusion Criteria ◽  
Upper Eyelid ◽  
Congenital Ptosis ◽  
Surgical Success ◽  
Suitable Treatment ◽  
The Difference

Összefoglaló. Bevezetés: Szemhéjcsüngésnek (ptosis vagy blepharoptosis) nevezzük azt az állapotot, amikor a felső szemhéj abnormálisan alacsony pozícióban van. A szemhéjcsüngésnek lehetnek veleszületett és szerzett formái. Célkitűzés: Célunk volt bemutatni a szemhéjemelő izom (levator) – veleszületett szemhéjcsüngés korrekciója céljából végzett – kötőhártya felőli redőzésének eredményeit retrospektív módszerrel. Módszer: 20 beteg 22 szemhéján végeztük el a műtétet (átlagéletkor: 19,4 ± 9,9 év, férfi: 12 [60%], nő: 8 [40%]). Beválasztási kritérium volt a közepes (5–8 mm) vagy jó (9 mm felett) levatorfunkció. Kizártuk a korábban szemhéjkorrekciós műtéten átesett és a 3 hónapnál rövidebb követési idővel rendelkező betegeket. A műtét előtt megmértük a levatorfunkciót és a margó–reflex-távolságot. A műtét után megmértük a margó–reflex-távolságot, a szemhéjak magassága közti aszimmetria mértékét, és elemeztük a szemhéj posztoperatív kontúrját. Eredmények: A preoperatív levatorfunkció 10,6 ± 3,0 mm, a preoperatív margó–reflex-távolság 1,8 ± 0,8 mm volt. A 7,8 ± 7,2 hónap átlagos követési idő alatt a posztoperatív margó–reflex-távolság 3,2 ± 0,8 mm volt. A preoperatív és a posztoperatív margó–reflex-távolság különbsége nem tért el szignifikánsan a sikeres és a sikertelen műtétek között (p = 0,523). A szemhéjak magassága közti aszimmetria mértéke 3 betegnél haladta meg az 1 mm-t. A szemhéj posztoperatív kontúrja minden esetben megfelelő volt. A műtét összességében 86,4%-ban (19/22) volt sikeres. A helyi érzéstelenítésben és altatásban végzett műtétek közt nem találtunk szignifikáns különbséget a sikeresség tekintetében (p = 0,227). Következtetés: Tanulmányunk alapján az elvégzett műtéteink eredményessége a nemzetközi irodalomban közöltekhez hasonló volt. A veleszületett szemhéjcsüngés korrekciójára a kötőhártya felőli levatorredőzés megfelelő kezelési mód közepes vagy annál jobb levatorfunkció esetén. Orv Hetil. 2021; 162(18): 705–711. Summary. Introduction: Droopy eyelid (ptosis or blepharoptosis) is defined through abnormally low upper eyelid position. Ptosis can be classified as congenital or acquired. Objective: Our purpose was to report the results of posterior approach levator plication for congenital ptosis in a retrospective review. Method: 22 eyelids of 20 patients were included in this study (age: 19.4 ± 9.9 years, male: 12 [60%], female: 8 [40%]). The inclusion criteria were moderate (5–8 mm) or good (more than 9 mm) levator function. Patients with postoperative follow-up time shorter than 3 months and those who underwent previous eyelid surgery were excluded. The data collected included preoperative levator function and margin reflex distance, postoperative margin reflex distance, inter-eyelid height asymmetry and postoperative eyelid contour. Results: Preoperative levator function was 10.6 ± 3.0 mm, preoperative margin reflex distance was 1.8 ± 0.8 mm. During 7.8 ± 7.2 months postoperative follow-up, postoperative margin reflex distance was 3.2 ± 0.8 mm. The difference between preoperative and postoperative margin reflex distance was not significant (p = 0.523) in the group of successful operations compared with unsuccessful operations. Inter-eyelid height asymmetry was more than 1 mm in 3 cases. Satisfactory postoperative eyelid contour was achieved in all cases. Overall success rate was 86.4% (19/22). Surgical success did not differ significantly between surgeries in local or general anaesthesia (p = 0.227). Conclusion: Our study shows an overall success rate of the procedures comparable to those in international publications. Posterior approach levator plication for congenital ptosis with moderate or better levator function seems to be a suitable treatment method. Orv Hetil. 2021; 162(18): 705–711.

scholarly journals A Surgically Treated Case of Ureterovesical Amyloidosis of the Bladder in a Patient with Idiopathic Thrombocytopenia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Sung Han Kim ◽  
Weon Seo Park ◽  
Jae Young Joung ◽  
Kang Hyun Lee ◽  
Jinsoo Chung ◽  
...  
Keyword(s):  
Bleeding Disorder ◽  
Ureteral Orifice ◽  
Gross Hematuria ◽  
Computed Tomography Imaging ◽  
Ureterovesical Junction ◽  
Tomography Imaging ◽  
Idiopathic Thrombocytopenia ◽  
Amyloid Deposits ◽  
Bladder Mass

Idiopathic thrombocytopenia (ITP) is a bleeding disorder involving the destruction of platelets by the immune system. Systemic amyloidosis is another bleeding disorder involving amyloid deposits that create defects in coagulation and increased prothrombin and thrombin times. We report a 52-year-old man with ITP and new two-month-duration, painless gross hematuria without clot formation resulting in amyloidosis involving the ureterovesical area of the bladder. He had osteopenia, hypertension, and moderate thrombocytopenia due to ITP diagnosed 7 years previously. Cystoscopic examination with urine cytology and computed tomography imaging detected a 2-cm protruding solid bladder mass involving the left ureteral orifice and trigone and left mild hydroureteronephrosis, suggesting bladder cancer. Transurethral resection of the bladder mass was performed to confirm amyloidosis involvement in the ureterovesical junction of the bladder and ureter. Four weeks postoperatively, intermittent gross hematuria remained; hence, left ureteroneocystostomy was performed. Regular follow-up showed no signs of hematuria or intravesical recurrences for 14 months.

scholarly journals Follow-up of iatrogenic aorto-coronary "Dunning" dissections by cardiac computed tomography imaging

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Stefan Baumann ◽  
Michael Behnes ◽  
Benjamin Sartorius ◽  
Tobias Becher ◽  
Ibrahim El-Battrawy ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Computed Tomography ◽  
Computed Tomography Imaging ◽  
Tomography Imaging

scholarly journals Coflex Interspinous Process Dynamic Stabilization for Lumbar Spinal Stenosis: Long-term Follow-up

2020 ◽  
Author(s):  
Mingrui Du ◽  
Fei-Long Wei ◽  
Kai-Long Zhu ◽  
Cheng-Pei Zhou ◽  
Ji-Xian Qian
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Dynamic Stabilization ◽  
Adjacent Segment ◽  
Imaging Data ◽  
Process Dynamic ◽  
The Difference ◽  
Lumbar Spinal

Abstract [Objective]To evaluate the long-term efficacy of Coflex interspinous process dynamic stabilization device in the treatment of lumbar spinal stenosis.[Methods]The clinical and imaging data of 73 patients undergoing Coflex interspinous process dynamic stabilization surgery from July 2008 to June 2012 were retrospectively analyzed. Clinical data include: visual analogue scale of pain (VAS), Owestry disability index(ODI) and Japanese Orthopedic Association Scores(JOA) of preoperation, 6 months after surgery, and last follow-up; complications; reoperation rates and incidence of adjacent segment degeneration(ASD). Imaging data including: lumbar range of motion(ROM), intervertebral space height(ISH) and intervertebral foramen height (IFH) of operative and adjacent segment at preoperative, 6 months after operation and the last follow-up.[Results]56 patients were followed up. The follow-up time was 107.6 ± 13.3 months, the operation time was 10.0 ± 3.1 minutes, the intraoperative blood loss was 153.9 ± 80.6 ml, and the hospitalization time was 10.2 ± 3.2 days. The VAS, ODI and JOA scores improved significantly after surgery. At 6 months after surgery and the last follow-up, ROM was significantly lower than that before surgery with statistical significance (P < 0.001). ROM was slightly increased at the last follow-up compared with that 6 months after operation, but the difference was not statistically significant (P > 0.05). The ROM of adjacent segments increased at 6 months and at the last follow-up compared with that before surgery, but the difference was not statistically significant (P > 0.05). At 6 months after surgery, ISH and IFH of implanted segment was significantly higher than that before surgery, and the difference was statistically significant (P < 0.05). At the last follow-up, there was a decrease in ISH and IFH, with no statistical difference compared with that before the operation. During the follow-up period, a total of 11 patients (19.6%) experienced complications and 6 patients (10.7%) underwent secondary surgery.[Conclusion]Coflex interspinous process dynamic stabilization is effective in the treatment of lumbar spinal stenosis in the long term. The surgical segment retains a small range of motion. The incidence of complications and reoperation is low. However, the ISH and IFH of implanted segment can only be maintained for a short period of time.

scholarly journals Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

2021 ◽  
Author(s):  
Henghai Huang ◽  
Qijian Ding ◽  
XiaoCao Lin ◽  
DeLin Li ◽  
Jingjing Zeng ◽  
...  
Keyword(s):  
Operative Management ◽  
Pathological Examination ◽  
Computed Tomography Imaging ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Tomography Imaging ◽  
Male Female Ratio ◽  
The Mean ◽  
The Right

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

scholarly journals Use of Dual Energy Computed Tomography Imaging to follow up Stent-assisted Coil Embolization

2015 ◽  
Vol 24 (9) ◽  
pp. 614-621
Author(s):  
Toshiyuki Onda ◽  
Daisuke Sasamori ◽  
Yasuyuki Yonemasu ◽  
Yuji Hashimoto ◽  
Osamu Honda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coil Embolization ◽  
Dual Energy ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Dual Energy Computed Tomography

scholarly journals Non-syndromic pheochromocytoma: From post-operatory scores to lifetime follow-up

2021 ◽  
Vol 16 (3) ◽  
pp. 394-397
Author(s):  
Mihai Cristian DUMITRASCU ◽  
◽  
Diana Elena BECHERU ◽  
Eugenia PETROVA ◽  
Anda DUMITRASCU ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Adrenal Tumor ◽  
First Year ◽  
Tumor Removal ◽  
Computed Tomography Imaging ◽  
Intravenous Contrast ◽  
Tomography Imaging ◽  
Hormonal Imbalance ◽  
Pathological Report

We introduce a case report of an adult male diagnosed with non-syndromic pheochromocytoma with a first pathological post-operatory report of malignant type with further re-considerations during follow-up for a 6-year period of time. This is 46 - year old male admitted for: post-adrenalectomy status reassessment. In 2013 he was diagnosed with high blood pressure requiring a complex regime of anti-hypertensive drugs to control it. In 2015 he was referred for an endocrine check-up which revealed a pheochromocytoma (noradrenaline type). Computed tomography imaging of the abdomen showed a right adrenal tumor of 28/38 mm, a mass that was clearly contoured, with heterogeneous pattern, and with moderate caption of intravenous contrast. Laparoscopic right adrenalectomy is performed with normalization of high pre-operatory normetanephrines and a dose reduction of anti-hypertensive medication which was still necessary. Pathological report suggested a malignant pheochromocytoma; the initial PASS score of 8 was later re-calculated, and a GAPP score of 5 was achieved showing a moderately differentiated tumor. No genetic backup was identified. Within the first year after tumor removal, the patient suffered a stroke, proving the higher cardiovascular risk than general population even after hormonal imbalance is restored. Lifelong surveillance is the rule.

Sign in / Sign up

Export Citation Format

Share Document