Complication Rate of Transtemporal Hydroxyapatite Cement Cranioplasties: A Case Series Review of 76 Cranioplasties

2004 ◽  
Vol 25 (4) ◽  
pp. 604-609 ◽  
Author(s):  
David M. Poetker ◽  
Kristen B. Pytynia ◽  
Glenn A. Meyer ◽  
P. Ashley Wackym
Keyword(s):  
Complication Rate ◽  
Case Series ◽  
Hydroxyapatite Cement

scholarly journals Comparative outcome analysis of bleb needling of fibrotic blebs in the clinic versus the operating room: a retrospective case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vikram Ponnusamy ◽  
Van Nguyen ◽  
Jella A. An
Keyword(s):  
Success Rate ◽  
Operating Room ◽  
Complication Rate ◽  
Primary Outcome ◽  
Case Series ◽  
Outcome Analysis ◽  
Retrospective Case ◽  
Xen Gel Stent ◽  
Retrospective Case Series ◽  
Ab Interno

Abstract Background To compare 6 month outcomes of bleb needling performed in the clinic vs. the operating room (OR) in adult glaucoma patients with failed bleb. Methods A retrospective case series of 47 eyes from 41 glaucoma patients who received needling with mitomycin C (MMC) of scarred bleb from prior bleb-forming procedures in clinic (32 eyes) vs. the OR (15 eyes), including trabeculectomy (14 eyes), ExPress shunt (16 eyes), and ab-interno XEN gel stent (17 eyes). The primary outcome was needling success, defined as IOP ≤ 18 mmHg on 0 glaucoma medications without requiring an additional IOP lowering procedure within 6 months after needling. Results At 6 months, bleb needling success rate was similar when performed in the clinic vs. in the OR (28% vs. 20%, P = 0.54). Success rate was not statistically different in patients with prior trabeculectomy, ExPress shunt, and XEN gel stent (29% vs. 38% vs. 12%, P = 0.26). When comparing clinic vs. the OR needling procedures at 6 months, there was no difference in mean IOP (14.2 vs. 14.9 mmHg, P = 0.73), mean glaucoma medications (1.4 vs. 1.7, P = 0.69), additional IOP-lowering procedure rate (16% vs. 27%, P = 0.37), or complication rate (0% vs. 7%, P = 0.32). Conclusion Bleb needling with MMC in clinic may be a safe and effective way to revise failed bleb after trabeculectomy, ExPress shunt, and XEN gel stent procedures when compared to needling in the OR.

scholarly journals Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article)

2020 ◽  
Author(s):  
C. Herrera-Vizcaino ◽  
L. Seifert ◽  
M. Berdan ◽  
S. Ghanaati ◽  
M. Klos ◽  
...  
Keyword(s):  
Complication Rate ◽  
Orthognathic Surgery ◽  
Mouth Opening ◽  
Case Series ◽  
Operation Time ◽  
University Hospital ◽  
Material Failure ◽  
Retrospective Case ◽  
Non Union ◽  
Facial Plastic

Abstract Background The high-oblique sagittal osteotomy (HOSO) is an alternative to a bilateral sagittal split osteotomy (BSSO). Due to its novelty, there are no long-term studies which have focused on describing the incidence and type of complications encountered in the post-operative follow-up. The aim of this retrospective study is to analyze patients operated on with this surgical technique and the post-operative complications encountered. Patient and methods The electronic medical records of all patients treated with orthognathic surgery at the Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany, between the years 2009 and 2016 were retrospectively reviewed. Results A total of 116 patients fulfilled the inclusion criteria. The cases operated on with the standard osteosynthesis (X, Y, and straight) showed a complication rate of 36.37% (n = 4/11). The cases operated on with the HOSO-dedicated plates (HOSO-DP) showed, in total, a complication rate of 6.67% (n = 7/105). The most common post-operative complication resulting from both fixation methods was a reduction in mouth opening and TMJ pain for 4.3%. During the first years of performing the surgery (2009–211), a variety of standard plates had material failure causing non-union or pseudarthrosis. No cases of material failure were observed in the cases operated on with the HOSO-DP. The statistical results showed a highly significant dependence of a reduction in OP-time over the years, when the HOSO was performed without additional procedures (R2 > 0.83, P < 0.0015). Conclusion The rate of complications in the HOSO were shown to be comparable to the rate of complications from the BSSO reported in the literature. Moreover, the use of the ramus dedicated plate appears to provide enough stability to the bone segments, making the surgery safer. Clinical relevance The HOSO needs to be considered by surgeons as an alternative to BSSO. Once the use of the HOSO-DP was established, the rate of complications and the operation time reduced considerably.

A Retrospective Case Series of Carbon Fiber Plate Fixation of Ankle Fractures

2017 ◽  
Vol 11 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Zachariah W. Pinter ◽  
Kenneth S. Smith ◽  
Parke W. Hudson ◽  
Caleb W. Jones ◽  
Ryan Hadden ◽  
...  
Keyword(s):  
Carbon Fiber ◽  
Fracture Fixation ◽  
Complication Rate ◽  
Ankle Fracture ◽  
Case Series ◽  
Complication Rates ◽  
Union Rate ◽  
Retrospective Case ◽  
Retrospective Case Series

Distal fibula fractures represent a common problem in orthopaedics. When fibula fractures require operative fixation, implants are typically made from stainless steel or titanium alloys. Carbon fiber implants have been used elsewhere in orthopaedics for years, and their advantages include a modulus of elasticity similar to that of bone, biocompatibility, increased fatigue strength, and radiolucency. This study hypothesized that carbon fiber plates would provide similar outcomes for ankle fracture fixation as titanium and steel implants. A retrospective chart review was performed of 30 patients who underwent fibular open reduction and internal fixation (ORIF). The main outcomes assessed were postoperative union rate and complication rate. The nonunion or failure rate for carbon fiber plates was 4% (1/24), and the union rate was 96% (23/24). The mean follow-up time was 20 months, and the complication rate was 8% (2/24). Carbon fiber plates are a viable alternative to metal plates in ankle fracture fixation, demonstrating union and complication rates comparable to those of traditional fixation techniques. Their theoretical advantages and similar cost make them an attractive implant choice for ORIF of the fibula. However, further studies are needed for extended follow-up and inclusion of larger patient cohorts. Levels of Evidence: Level IV: Retrospective Case series

Use of 2-Octylcyanoacrylate (Dermabond) Tissue Adhesive for Tip Graft Fixation in Open Rhinoplasty

2011 ◽  
Vol 145 (5) ◽  
pp. 737-741 ◽  
Author(s):  
Jin-Young Min ◽  
Yong Ju Jang
Keyword(s):  
Complication Rate ◽  
Soft Tissues ◽  
Costal Cartilage ◽  
Tertiary Care ◽  
Case Series ◽  
Tissue Adhesive ◽  
Open Rhinoplasty ◽  
External Approach ◽  
Cartilage Grafts ◽  
Nasal Tip

Objectives. To describe the use of 2-octylcyanoacrylate (2-OCA; Dermabond) for fixation of cartilage grafts in nasal tip surgery via an external approach in Asian patients. Study Design. Case series with chart review. Setting. Academic tertiary care medical center. Subjects and Methods. This retrospective study analyzed data from 33 Korean patients who underwent open rhinoplasty using 2-OCA tissue adhesive for fixation of cartilage grafts in tip surgery. Autologous septal, conchal, costal, or homologous costal cartilage was used as graft materials. Layers of cartilages were bonded using 2-OCA tissue adhesive, and care was taken to prevent the tissue adhesive from spilling and directly contacting surrounding soft tissues. Preoperative and postoperative photographs were reviewed for objective and subjective assessment of aesthetic outcomes. Results. Postoperative aesthetic outcomes were graded as excellent in 51.5%, fair in 33.3%, and no change/worse in 15.2% of patients. Preoperative and postoperative anthropometric measurements showed that the nasal tip projection increased (0.53 ± 0.03 vs 0.57 ± 0.05; P < .05) and the nasolabial angle improved (92.54 ± 6.95 vs 96.12 ± 5.20; P < .05). The overall complication rate was 24.2%, and complications included erythema (9.1%), infection (12.1%), and aesthetic dissatisfaction (3.0%). Conclusion. Although using 2-OCA tissue adhesive for tip surgery simplifies the surgical procedures of fixating graft materials, the relatively high complication rate may preclude its use in nasal tip surgery via an external approach for Asian noses.

scholarly journals Tensor fascia lata flap is a workhorse for defects after inguinal lymph node block dissection

2016 ◽  
Vol 144 (5-6) ◽  
pp. 288-292
Author(s):  
Asen Velickov ◽  
Predrag Kovacevic ◽  
Aleksandra Velickov
Keyword(s):  
Lymph Node ◽  
Complication Rate ◽  
Inguinal Lymph Node ◽  
Donor Site ◽  
Case Series ◽  
Fascia Lata ◽  
Tumor Type ◽  
Tensor Fascia Lata ◽  
Immediate Reconstruction ◽  
Tfl Flap

Introduction. Enlarged inguinal lymph nodes very often present a site of metastatic disease. Inguinal lymph node block dissection is a demanding procedure, which usually requires at least one of reconstructive modalities. Among different reconstruction options we selected the tensor fascia lata (TFL) musculocutaneous flap. Objective. The paper aims at presenting a series of inguinal block dissections, followed by immediate reconstruction, using the TFL flap, and evaluation of tumor type, flap dimension, complication rate and the duration of hospital stay. Methods. We present a consecutive case series of 25 conducted block dissections. The defects were reconstructed using TFL flap, because of the extent and site of the tissue defects, reliability of the flap, and potentially primarily infected exulcerated tumors. Results. The reconstruction was successful in all cases, the incidence of surgical complications was 16%, no further complications, such as lymphedema or gait disturbances, were noted. Primary skin tumors were predominant (13 cases), followed by genitalia tumors (four cases). The male sex was more frequently affected (14 vs. 11 cases). Conclusion. Having in mind that TFL presents as a flap of adjustable size, length, shape, and volume, with negligible donor site morbidity, and after comparing of our results to those of other authors, we advise broader use of TFL flap. As a reliable flap, not too difficult to harvest, with a low complication rate, it must be taken into consideration regarding the benefits for the patient, and, on the other hand, the surgery cost and duration.

scholarly journals Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis

2017 ◽  
Vol 132 (1) ◽  
pp. 14-21 ◽  
Author(s):  
P D Chakravarty ◽  
A E L McMurran ◽  
A Banigo ◽  
M Shakeel ◽  
K W Ah-See
Keyword(s):  
Systematic Review ◽  
Complication Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Current Evidence ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Voice Restoration ◽  
Increased Risk ◽  
Tracheoesophageal Puncture

AbstractBackground:Tracheoesophageal puncture represents the ‘gold standard’ for voice restoration following laryngectomy. Tracheoesophageal puncture can be undertaken primarily during laryngectomy or in a separate secondary procedure. There is no current consensus on which approach is superior. The current evidence comparing primary and secondary tracheoesophageal puncture was assessed.Methods:A systematic review and meta-analysis of articles comparing outcomes for primary and secondary tracheoesophageal puncture after laryngectomy were conducted. Outcome measures were: voice success, overall complication rate and pharyngocutaneous fistula rate.Results:Eleven case series met the inclusion criteria, two prospective and nine retrospective. Meta-analysis did not demonstrate statistically significant differences in overall complication rate or voice outcomes, though it suggested a significantly increased risk of pharyngocutaneous fistula in primary compared to secondary tracheoesophageal puncture.Conclusion:Primary tracheoesophageal puncture is a safe and efficient approach for voice rehabilitation. However, secondary tracheoesophageal puncture should be preferred where there is a higher risk of pharyngocutaneous fistula.

Compartmentalization: An Open Technique for Frontal Sinus Repair and Preservation—Description of Technique and Early Case Series

2019 ◽  
Author(s):  
Christopher Miller ◽  
Luke Weisbrod ◽  
David Beahm ◽  
Roukoz Chamoun
Keyword(s):  
Complication Rate ◽  
Frontal Sinus ◽  
Case Series ◽  
Csf Leak ◽  
Open Technique ◽  
Periosteal Flap ◽  
Short Course ◽  
Early Case ◽  
Patient Series ◽  
Neurosurgical Technique

Abstract Background Cranialization or obliteration is widely accepted intervention for traumatic or intentional breach of the frontal sinus. These techniques, however, result in the loss of frontal sinus function and have a persistent risk of cerebrospinal fluid (CSF) leak and mucocele. Compartmentalization is an open technique for repair of the frontal sinus using allograft onlay and a vascularized periosteal flap that allows for preservation of frontal sinus function. Objective The main objective of this article is to describe the technique for compartmentalization of the frontal sinus and demonstrate its efficacy and complication rate with an early patient series. Methods Our technique includes the following key components: harvesting of a pedicled periosteal flap, frontal sinus repair through a bifrontal craniotomy with minimal mucosa removal, ensuring the patency of the nasal frontal outflow tract, and separation of the brain from the frontal sinus with a dual layer of periosteum and allograft.All cases of frontal sinus repair using the compartmentalization technique at our institution were reviewed. Charts were reviewed for CSF leak, mucocele, and other complications. Results Twenty-three patients underwent the described frontal sinus repair technique 17 for tumor and 6 for trauma. There were no CSF leaks and no mucoceles. One patient experienced postoperative anemia and a “parameningeal reaction” that were managed with a short course of antibiotics. Conclusions Compartmentalization, due to its sinus preservation and low complication rate, represents a meaningful step forward in neurosurgical technique for open frontal sinus repair. However, long-term outcomes are necessary to fully evaluate risk of mucocele.

scholarly journals Deformity and Clinical Outcomes for Surgical Correction of Charcot Ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0024
Author(s):  
Elizabeth Harkin ◽  
Andrew Schneider ◽  
Michael Murphy ◽  
Adam Schiff ◽  
Michael Pinzur
Keyword(s):  
Clinical Outcomes ◽  
Complication Rate ◽  
Chronic Wounds ◽  
Sagittal Plane ◽  
Case Series ◽  
Surgical Correction ◽  
Surgical Reconstruction ◽  
Charcot Foot ◽  
Operative Complication

Category: Diabetes Introduction/Purpose: Charcot Foot is a complex neuro-arthropathy associated with acquired progressive deformity and a significant impact to patients’ quality of life. Recent reports have suggested that preoperative deformity is predictive of clinical outcomes following surgical correction of the acquired deformity associated with midtarsal diabetes-related Charcot Foot arthropathy. Methods: A retrospective analysis was performed of 56 patients who underwent surgical reconstruction of Charcot ankle arthropathy by a single surgeon over a 14-year time period. Preoperative tibiotalar alignment was reviewed in the coronal and sagittal plane. Preoperative patient characteristics including age, sex, hemoglobin A1c, BMI, insulin use, and presence of a wound or infection at the time of surgery were also recorded. Preoperative coronal plane deformity was observed as valgus 16/56 (28.6%), varus 31/56 (55.4%), and neutral 9/56 (16.1%). Surgery included debridement of active infection when present, corrective osteotomies, and an attempt at ankle arthrodesis with application of a ringed external fixator (39 of 56, 69.6%) when infection was present or retrograde intramedullary nail (17 of 56, 30.3%). Clinical outcomes of excellent, good, or poor were based on limb salvage, resolution of infection and chronic wounds, and the ability to ambulate with either a CROW, AFO, or therapeutic diabetic footwear. Results: The average total patient follow-up time from index surgery was 115.4 weeks. One patient died after 134.3 weeks of follow-up and 8 underwent amputation. The post-operative complication rate was 69.6% (39 of 56), 79.5% (31 of 39) of which underwent re-operation. Ultimately, only 25 of 55 patients (45.5%) achieved a favorable (excellent or good) clinical outcome. There was no meaningful association between surgical outcome, post-operative complication, reoperation, and amputation and patients’ pre-operative alignment, final alignment, treatment with either ex-fix or IMN, the presence of a wound or infection, age, HgA1c, or BMI. However, compared to insulin dependent diabetics, those not taking insulin were only 0.34 times as likely to have a poor outcome. Conclusion: Operative fixation of Charcot ankle arthropathy was performed with a goal of achieving a plantigrade post for ambulation void of infection or chronic wounds and easily accommodated with a supportive orthosis. This retrospective case series demonstrates a high complication rate in this complex patient population. Clinical outcomes of Charcot ankle can be used to counsel patients on the risks of surgical correction and as a benchmark for improved treatment strategies.

scholarly journals Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up

2020 ◽  
pp. bjophthalmol-2020-315954
Author(s):  
Eamon Sharkawi ◽  
Daniel Josef Lindegger ◽  
Paul H Artes ◽  
Lydia Lehmann-Clarke ◽  
Mohamad El Wardani ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Outcome Measures ◽  
Complication Rate ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Polypropylene Suture ◽  
Pseudoexfoliative Glaucoma ◽  
Ab Interno

AimTo report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG).MethodsProspective, interventional, non-comparative case series. A total of 103 eyes from 84 patients with PXG were enrolled to undergo a 360-degree ab interno trabeculotomy with gonioscopic assistance using either a 5.0 polypropylene suture or an illuminated microcatheter with up to 24 months of follow-up. Main outcome measures were intraocular pressure (IOP), number of antiglaucoma medications, success rate (IOP reduction ≥20% from baseline or IOP between 6 and 21 mm Hg, without further glaucoma surgery) and complication rate.ResultsMean preoperative IOP was 27.1 mm Hg (95% CI 25.5 to 28.7) using 2.9 (SD 1.1) glaucoma medications which decreased postoperatively to 13.0 mm Hg (95% CI 11.5 to 14.4) and 1.0 (SD 1.1) medications at 24 months (p<0.001). Success rate was 89.2% at 24 months of follow-up, and complication rate was 2.9%.ConclusionAt 24 months of follow-up, our results for GATT in PXG demonstrate that this conjunctival sparing procedure effectively lowers IOP and reduces the medications with a low complication rate, in this relatively aggressive glaucoma subtype.

Characteristic Complications after Autologous Chondrocyte Implantation for Cartilage Defects of the Knee Joint

2008 ◽  
Vol 36 (11) ◽  
pp. 2091-2099 ◽  
Author(s):  
Philipp Niemeyer ◽  
Jan M. Pestka ◽  
Peter C. Kreuz ◽  
Christoph Erggelet ◽  
Hagen Schmal ◽  
...  
Keyword(s):  
Knee Joint ◽  
Revision Surgery ◽  
Complication Rate ◽  
Autologous Chondrocyte Implantation ◽  
Case Series ◽  
Cartilage Defects ◽  
Level Of Evidence ◽  
Therapeutic Concepts ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Background Although autologous chondrocyte implantation (ACI) is a well-established therapy for the treatment of isolated cartilage defects of the knee joint, little is known about typical complications and their treatment after ACI. Hypothesis Unsatisfactory outcome after ACI is associated with technique-related typical complications. Study Design Case series; Level of evidence, 4. Methods A total of 309 consecutive patients with 349 ACI procedures of the knee joint were analyzed. Three different ACI techniques were used: periosteum-covered ACI in 52 cases (14.9%), Chondrogide (Geistlich Biomaterials, Wolhusen, Switzerland) membrane-covered ACI in 215 cases (61.6%), and a 3-dimensional matrix-associated ACI (BioSeed-C, Biotissue Technologies, Freiburg, Germany) in 82 cases (23.5%). In 52 patients, revision surgery was performed for persistent clinical problems. These patients were analyzed for defect size and location, technique of ACI, and intraoperative findings during revision surgery. The mean time of follow-up for patients after ACI was 4.5 years (standard deviation, ±1.5). Results Four typical major complications were identified: hypertrophy of the transplant, disturbed fusion of the regenerative cartilage and the healthy surrounding cartilage, insufficient regenerative cartilage, and delamination. These diagnoses covered a total of 88.5% of the patients who underwent revision surgery. The overall complication rate was highest in the group of patients treated with periosteum-covered ACI ( P = .008). The incidence of symptomatic hypertrophy was 5.2% for all techniques and defect locations; the highest incidence was in patients treated with periosteum-covered ACI (15.4%) ( P = .001). The incidence of disturbed fusion was highest in the Chondrogide-covered ACI (3.7%) and the matrix-associated ACI group (4.8%). Concerning the incidence of complications by defect location, there was a tendency for increased complications in patellar defects ( P = .095). Within the patellar defects group, no correlation was found for the occurrence of delamination, insufficient regeneration, and disturbed fusion. As a statistical trend, an increased rate of hypertrophy was found for patellar defects ( P = .091). Conclusion A major proportion of complications after ACI can be summarized by 4 major diagnoses (symptomatic hypertrophy, disturbed fusion, delamination, and graft failure). Among those, the overall complication rate and incidence of hypertrophy of the transplant were higher for periosteum-covered ACI. Furthermore, an increased rate of symptomatic hypertrophy was found for patellar defects. Therapeutic concepts need to be developed to treat these typical complications of ACI.

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