scholarly journals Microdebrider-Assisted Rhinophyma Excision

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Abdulaziz Abushaala ◽  
Marios Stavrakas ◽  
Hisham Khalil
Keyword(s):  
Operating Time ◽  
Case Series ◽  
Uneventful Recovery ◽  
Postoperative Infections ◽  
Gland Tissue ◽  
Aesthetic Results ◽  
Cosmetic Outcomes ◽  
Safe Approach

Rhinophyma represents a progressive deformity of the nose which leads to cosmetic disfigurement and has a significant impact on the patient’s quality of life. This pathological entity originates from hyperplasia of sebaceous gland tissue, connective tissue, and vessels of the nose and is associated with rosacea and more specifically, stage III rosacea. Surgical treatment is the method of choice. We present five cases of rhinophyma that we treated with microdebrider-assisted excision. The procedure was divided in two main steps: scalpel excision of the main bulk of the rhinophyma and then further contouring with the microdebrider. All patients had weekly follow-up for the first four weeks, and then three-monthly. All patients had uneventful recovery and satisfactory cosmetic outcomes. No postoperative infections or other complications were reported in our case series. The use of the microdebrider reduces the operating time, preserves the islands of skin regeneration, and allows finer manipulations than the standard scalpel techniques. Microdebrider-assisted rhinophyma excision is a safe approach, with good aesthetic results. Larger series of patients need to be examined in order to establish the value of the method.

scholarly journals Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up

2021 ◽  
pp. 219256822110091
Author(s):  
Yu-Cheng Yao ◽  
Han Jo Kim ◽  
Mathieu Bannwarth ◽  
Justin Smith ◽  
Shay Bess ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Operating Time ◽  
Patient Demographics ◽  
Lowest Instrumented Vertebra ◽  
Related Quality ◽  
Health Related

Study Design: Retrospective cohort study. Objective: To compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium. Methods: A multicenter ASD database was evaluated. Patients were categorized into 2 groups based on LIV levels—groups L (fusion to L4/L5) and S (fusion to S1/ilium). Both groups were propensity matched by age and preoperative radiographic alignments. Patient demographics, operative details, radiographic parameters, revision rates, and health-related quality of life (HRQOL) scores were compared. Results: Overall, 349 patients had complete data, with a mean follow-up of 46 months. Patients in group S (n = 311) were older and had larger sagittal and coronal plane deformities than those in group L (n = 38). After matching, 28 patients were allocated to each group with similar demographic, radiographic, and clinical parameters. Sagittal alignment restoration at postoperative week 6 was significantly better in group S than in group L, but it was similar in both groups at the 2-year follow-up. Fusion to S1/ilium involved a longer operating time, higher PJK rates, and greater PJK angles than that to L4/L5. There were no significant differences in the complication and revision rates between the groups. Both groups showed significant improvements in HRQOL scores. Conclusions: Fusion to S1/ilium had better sagittal alignment restoration at postoperative week 6 and involved higher PJK rates and greater PJK angles than that to L4/L5. The clinical outcomes and rates of revision surgery and complications were similar between the groups.

Outcomes of the Modified Endoscopic Lothrop Procedure

2002 ◽  
Vol 16 (5) ◽  
pp. 269-273 ◽  
Author(s):  
Stacey L. Schulze ◽  
Todd A. Loehrl ◽  
Timothy L. Smith
Keyword(s):  
Case Series ◽  
Good Alternative ◽  
Frontal Sinusitis ◽  
Long Term Outcomes ◽  
Postoperative Patient ◽  
Perceived Quality Of Life ◽  
Telephone Questionnaire

Background The aim of this study was to examine the long-term outcomes of the modified endoscopic Lothrop procedure for the management of the most severe forms of recalcitrant chronic frontal sinusitis. Methods This case series evaluated 13 consecutive cases of the modified endoscopic Lothrop procedure for chronic frontal sinusitis from April 1996 to December 1999. Patent communication to the frontal sinus was evaluated by postoperative endoscopic exam. Postoperative patient symptomatology and medication requirements were assessed during clinic evaluation and by standardized telephone questionnaire. Results At a mean follow-up period of 34.5 months, a 77% patency rate was obtained, with 2 of the 13 patients requiring an osteoplastic flap with obliteration. Telephone questionnaire results indicate improved symptoms and decreased medication requirements in the majority of patients who maintained patency. Conclusions These results show that the modified endoscopic Lothrop procedure provides a good alternative to the osteoplastic flap with obliteration for patients with the most severe forms of chronic frontal sinusitis. Initially, high patency rates decline with longer-term follow-up, and severe forms of chronic rhinosinusitis continue to significantly impact patient-perceived quality of life in some patients. The modified endoscopic Lothrop procedure should be reserved for patients who have failed more conservative endoscopic approaches to the frontal recess.

Long-term Outcomes of Deep Brain Stimulation for Neuropathic Pain

Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. 221-231 ◽  
Author(s):  
Sandra G.J. Boccard ◽  
Erlick A.C. Pereira ◽  
Liz Moir ◽  
Tipu Z. Aziz ◽  
Alexander L. Green
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Short Form ◽  
Case Series ◽  
Mcgill Pain Questionnaire ◽  
Euroqol 5D ◽  
Deep Brain

Abstract BACKGROUND: Deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy has reported variable outcomes and has gained United Kingdom but not USA regulatory approval. OBJECTIVE: To prospectively assess long-term efficacy of DBS for chronic neuropathic pain in a single-center case series. METHODS: Patient reported outcome measures were collated before and after surgery, using a visual analog score, short-form 36-question quality-of-life survey, McGill pain questionnaire, and EuroQol-5D questionnaires (EQ-5D and health state). RESULTS: One hundred ninety-seven patients were referred over 12 years, of whom 85 received DBS for various etiologies: 9 amputees, 7 brachial plexus injuries, 31 after stroke, 13 with spinal pathology, 15 with head and face pain, and 10 miscellaneous. Mean age at surgery was 52 years, and mean follow-up was 19.6 months. Contralateral DBS targeted the periventricular gray area (n = 33), the ventral posterior nuclei of the thalamus (n = 15), or both targets (n = 37). Almost 70% (69.4%) of patients retained implants 6 months after surgery. Thirty-nine of 59 (66%) of those implanted gained benefit and efficacy varied by etiology, improving outcomes in 89% after amputation and 70% after stroke. In this cohort, >30% improvements sustained in visual analog score, McGill pain questionnaire, short-form 36-question quality-of-life survey, and EuroQol-5D questionnaire were observed in 15 patients with >42 months of follow-up, with several outcome measures improving from those assessed at 1 year. CONCLUSION: DBS for pain has long-term efficacy for select etiologies. Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.

scholarly journals Tucked and treated- a case series on outcome of meshplasty with abdominoplasty for incisional hernia

2021 ◽  
Vol 8 (11) ◽  
pp. 3421
Author(s):  
Nagamallesh C. S. ◽  
Nandini S. Tanwar ◽  
F. Sadiq Nawaz ◽  
Padmanath Bhat
Keyword(s):  
Quality Of Life ◽  
Incisional Hernia ◽  
Previous History ◽  
Case Series ◽  
Weight Lifting ◽  
Aesthetic Outcome ◽  
Strict Glycemic Control ◽  
History Of

Incisional hernia is the second most common type of hernia. Incisional hernia occurs in 10-20% of patients who were subjected to abdominal surgery in India. Here we are presenting a case series of 20 patients with incisional hernia and obesity. Body mass index (BMI) ranges from 28 to 35 in all cases. Females outnumbered the male in the ratio of 4:1 and 40% of cases had a previous history of caesarean section. All cases were operated by combining open polypropylene meshplasty and abdominoplasty techniques and follow up consultations were done for 1 year. 10% of cases had post-op wound infections, who were known to be diabetic. They were managed with appropriate antibiotics and maintained strict glycemic control. 90% of patients were satisfied from the procedure performed which improved their quality of life, significant cosmetic outcome and no recurrence. 10% of cases had recurrence after heavy weight lifting following surgery (BMI was 36). By incorporating the above mentioned techniques in hernia repair, recurrence rate and complications were reduced, quality of life and aesthetic outcome are enhanced.

scholarly journals Laparoscopic Vaginoplasty Procedure Using a Modified Peritoneal Pull-Down Technique with Uterine Strand Incision in Patients with Mayer–Rokitansky–Küster–Hauser Syndrome: Kisu Modification

2021 ◽  
Vol 10 (23) ◽  
pp. 5510
Author(s):  
Iori Kisu ◽  
Miho Iida ◽  
Kanako Nakamura ◽  
Kouji Banno ◽  
Tetsuro Shiraishi ◽  
...  
Keyword(s):  
Case Series ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Mrkh Syndrome ◽  
Structural Support ◽  
Age At Surgery ◽  
The Mean ◽  
Safe Approach ◽  
Anatomical Success

Various vaginoplasty procedures have been developed for patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome. Here, we describe a novel laparoscopic vaginoplasty procedure, known as the Kisu modification, using a pull-down technique of the peritoneal flaps with additional structural support to the neovaginal apex using the incised uterine strand in patients with MRKH syndrome. Ten patients with MRKH syndrome (mean age at surgery: 23.9 ± 6.5 years, mean postoperative follow-up period: 17.3 ± 3.7 months) underwent construction of a neovagina via laparoscopic vaginoplasty. All surgeries were performed successfully without complications. The mean neovaginal length at discharge was 10.3 ± 0.5 cm. Anatomical success was achieved in all patients, as two fingers were easily introduced, the neovagina was epithelialized, and the mean neovaginal length was 10.1 ± 1.0 cm 1 year postoperatively. No obliteration, granulation tissue formation at the neovaginal apex, or neovaginal prolapse was recorded. Five of the 10 patients attempted sexual intercourse and all five patients were satisfied with the sexual activity, indicating functional success. Although the number of cases in this case series is few, our favorable experience suggests that the Kisu modification of laparoscopic vaginoplasty procedure is an effective, feasible, and safe approach for neovaginal creation in patients with MRKH syndrome.

scholarly journals Tendoscopic management of posterior tibial tendinitis

2020 ◽  
Vol 14 (2) ◽  
pp. 168-172
Author(s):  
Alberto Auellar-Avaroma ◽  
Ana Cristina King-Martinez
Keyword(s):  
Case Series ◽  
Posterior Tibial Tendon ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Important Improvement ◽  
Number Of Patients ◽  
Patient Reported ◽  
Vas Scores ◽  
Cosmetic Outcomes

Objective: The aim of this study was to present a case series of patients undergoing posterior tibial tendoscopy, assess their clinical outcome, and describe surgical findings and treatment complications. Methods: This is a clinical, retrospective, observational study of 11 consecutive cases of tenosynovitis of the posterior tibial tendon. All 11 patients underwent tendoscopy of the posterior tibial tendon. All procedures were performed by the same surgeon in 2 different hospitals. Minimum follow-up was 2 years. Results: All patients had their preoperative and postoperative AOFAS and VAS scores assessed. Both scores had an important improvement at 12 months that persisted at 24 months. Moreover, 72.72% of the patients were very satisfied with the procedure, and no patient reported to be dissatisfied. Additionally, 90.91% of the patients had no postoperative complications. The present results are consistent with those previously reported in the literature. Conclusion: Endoscopic or tendoscopic repair of the posterior tibial tendon is a simple and reproducible procedure that provides good functional and cosmetic outcomes with a low complication rate. It is important to increase the number of patients in this series in order to expand our conclusions. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Tectal gliomas: assessment of malignant progression, clinical management, and quality of life in a supposedly benign neoplasm

2018 ◽  
Vol 44 (6) ◽  
pp. E15 ◽  
Author(s):  
Malte Mohme ◽  
Friederike S. Fritzsche ◽  
Klaus C. Mende ◽  
Jakob Matschke ◽  
Ulrike Löbel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Course ◽  
Case Series ◽  
Diffuse Astrocytoma ◽  
The Mean ◽  
Mean Time ◽  
Tectal Glioma ◽  
Astrocytoma Grade

OBJECTIVETectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology.METHODSClinical data analysis of 23 cases of tectal glioma (involving 9 children and 14 adults) was performed retrospectively. Radiographic data were analyzed longitudinally and MR images were evaluated for tumor volume, contrast enhancement, and growth progression. Quality of life was assessed using the EORTC BN20 and C30 questionnaires during follow-up in a subgroup of patients.RESULTSThe patients’ mean age at diagnosis was 29.2 years. The main presenting symptom at diagnosis was hydrocephalus (80%). Six patients were treated by primary tumor resection (26.1%), 3 patients underwent biopsy followed by resection (13.1%), and 3 patients underwent biopsy only (13.1%). For additional treatment of hydrocephalus, 14 patients (60.9%) received shunts and/or endoscopic third ventriculostomy. Radiographic tumor progression was observed in 47.9% of the 23 cases. The mean time between diagnosis and growth progression was 51.5 months, and the mean time to contrast enhancement was 69.7 months. Histopathological analysis was obtained in 12 cases (52.2%), resulting in 5 cases of high-grade glioma (3 cases of glioblastoma multiforme [GBM], grade IV, and 2 of anaplastic astrocytoma, grade III), 5 cases of pilocytic astrocytoma, 1 diffuse astrocytoma, and 1 ganglioglioma. Malignant progression was observed in 2 cases, with 1 case progressing from a diffuse astrocytoma (grade II) to a GBM (grade IV) within a period of 13 years. Quality-of-life measurements demonstrated distinct functional deficits compared to a healthy sample as well as glioma control cohorts.CONCLUSIONSAnalysis of this case series shows that a major subpopulation of tectal gliomas show progression and malignant transformation in children as well as in adolescents. These tumors therefore cannot be considered inert lesions and require histological confirmation and close follow-up. Quality-of-life questionnaires show that tectal glioma patients might benefit from special psychological support in emotional, social, and cognitive functionality.

scholarly journals LUMBAR SPINAL STENOSIS: EVALUATION OF PAIN AND LIFE QUALITY AFTER SURGICAL TREATMENT

2019 ◽  
Vol 18 (1) ◽  
pp. 37-42
Author(s):  
Gustavo Alvarenga ◽  
João Otávio Araújo Rotini ◽  
Leonardo Yukio Jorge Asano ◽  
Vinícius Alves de Andrade ◽  
André Evaristo Marcondes Cesar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Life Quality ◽  
Case Series ◽  
Level Of Evidence ◽  
The Mean ◽  
One Year ◽  
Lumbar Spinal

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.

scholarly journals Management of the Temporal Bone Fibrous Dysplasia With External Auditory Canal Stenosis and Secondary Cholesteatoma in an Asian Population: A 11-Case Series

2020 ◽  
pp. 014556132092792
Author(s):  
Kun Zhang ◽  
Peng Qu ◽  
Bing Wang ◽  
Endong Zhang ◽  
Bing Chen
Keyword(s):  
Hearing Loss ◽  
Fibrous Dysplasia ◽  
Temporal Bone ◽  
External Auditory Canal ◽  
Perioperative Complications ◽  
Case Series ◽  
Asian Population ◽  
Canal Stenosis

Objective: This article summarizes the experience of diagnosis and treatment of temporal bone fibrous dysplasia (FD) with external auditory canal (EAC) stenosis and secondary cholesteatoma in the Chinese population, in order to improve the quality of life of patients in the future. Methods: Eleven patients with FD of the temporal bone who underwent surgery were retrospectively reviewed. Results: All lesions originated from the temporal bone, and all involved of the EAC. There were 11 cases of cholesteatoma in the EAC, 4 cases of cholesteatoma in the middle ear. The most common symptoms were hearing loss (100%), tinnitus (36.4%), and otorrhea (36.4%). Two patients were severe-profound sensorineural hearing loss, and one patient was complicated with subperiosteal abscesses. All 11 patients underwent surgery. There were no perioperative complications in this series and median follow-up time was 4.2 years. Conclusion: Temporal bone FD remains a rare diagnosis, especially in the Asian population. The lesions mainly lead to stenosis of the EAC, especially at the osteochondral junction. Cholesteatoma is the main complication of this disease, which is secondary to occlusion of the EAC with the growth of the lesion. Canaloplasty of EAC combined with wide meatoplasty can provide excellent prognosis in most cases.

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