scholarly journals Efficacy of Altered Two-Point Fixation in Zygomaticomaxillary Complex Fracture

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jun Hyeok Kim ◽  
Ye Sol Kim ◽  
Deuk Young Oh ◽  
Young Joon Jun ◽  
Jong Won Rhie ◽  
...  
Keyword(s):  
Operation Time ◽  
Facial Asymmetry ◽  
Asymmetry Index ◽  
Patient Demographics ◽  
Before And After ◽  
Zygomaticomaxillary Complex Fracture ◽  
Eyebrow Incision ◽  
Group 2 ◽  
Zygomaticomaxillary Complex

Purpose. To reconstruct a zygomaticomaxillary complex (ZMC) fracture, zygomaticofrontal (ZF) suture is the most reliable site to assess anatomical alignment and to secure rigidity. It has been chosen primary site to be fixed, but approach through the lateral eyebrow incision may leave a visible scar. This study suggests altered two-point fixation of ZMC fracture without accessing the ZF suture. Methods. In the retrospective study, a total of 40 patients with ZMC fracture were divided into two groups (group 1, two-point fixation and group 2, three-point fixation). Patient demographics and follow-up were evaluated, and degree of reduction including cortical gaps of ZF and inferior orbital (IO) area, protruding difference of zygoma, and malar difference using asymmetry index were measured through preoperative and postoperative CT. Results. Preoperatively, the means of ZF displacement, IO displacement, protruding difference of zygoma, and facial asymmetry index between the groups were not statistically different. The result was the same after the operation. However, all variables were significantly different before and after surgery within each group. Moreover, mean operation time was significantly different between groups (P value = 0.026). Conclusion. Altered two-point fixation in ZMC fracture excluding incision approaching the ZF provides surgical efficacy and similar surgical outcomes to three-point fixation but offers reduced operation time and fewer complications.

scholarly journals Correction of Temporal Hollowing Deformity Using Serratus Anterior Muscle Flap

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Lan Sook Chang ◽  
Youn Hwan Kim ◽  
Sang Wha Kim
Keyword(s):  
Muscle Flap ◽  
Operation Time ◽  
Facial Asymmetry ◽  
Free Flaps ◽  
Frontal View ◽  
Serratus Anterior ◽  
Aesthetic Form ◽  
The Mean ◽  
Fascia Flap

Temporal hollowing deformity (THD) is a contour irregularity in the frontotemporal region, which results in facial asymmetry in the frontal view. Here, we present our clinical experience of correction of THD using serratus anterior (SA) muscle and fascia free flaps. Between March 2016 and December 2018, 13 patients presenting with THD were treated with SA free flap. The mean age of the patients was 47.8 years. The patients received craniectomy due to subarachnoid hemorrhage, epidural hematoma, or brain tumor. On average, correction of THD was performed 17 months after cranioplasty. The SA flap size ranged from 5 × 5   cm to 10 × 8   cm . The mean operation time was 107.3 minutes. All of the flaps survived without complications. The mean follow-up duration was 20.3 months. For correction of THD, the SA muscle and fascia flap is among the best candidates to permanently restore aesthetic form and symmetry.

scholarly journals Is It Necessary to Reduce Thoracolumbar Compression Fractures  with Intermediate Screws in the Fractured Vertebra?

2021 ◽  
Author(s):  
ZeJun Xing ◽  
Shuai Hao ◽  
XiaoFei Wu
Keyword(s):  
Blood Loss ◽  
Body Height ◽  
Pedicle Screws ◽  
Operation Time ◽  
Short Segment ◽  
Compression Fractures ◽  
Significant Difference ◽  
Before And After ◽  
Screw Group

Abstract PurposeTo compare the efficacy and safety of percutaneous short-segment pedicle screws fixation (PPSF) with or without intermediate screws (IS) for the treatment of thoracolumbar compression fractures.MethodsFrom January 2016 to March 2019, a retrospective study of 38 patients with thoracolumbar compression fractures conducted. The patients were divided into a 4-screw group (without IS) and a 6-screw group (with IS) according to whether pedicle screws were placed in the fractured vertebrae. Combined positional reduction effects with the technique of pre-contoured lordotic rods were used to reduce the fracture by lengthening the anterior column of the fractured vertebrae. The posterior structure of the fractured vertebrae was undertaken as the fulcrum point for both groups. The operation time, intra-operative blood loss, visual analogue scale (VAS), anterior vertebral body height (AVBH), segment kyphosis（SK）before and after operation and complications were recorded.ResultsAlthough the operation time and blood loss in the 6-screw group were higher than in the 4-screw group, difference was not significant (P＞0.05). There was no significant difference in VAS, AVBH and SK between the two groups (P＞0.05). Nevertheless, these results were significant differences between the preoperative and the immediate postoperative, between preoperative and follow-up groups (P < 0.001). No neurologic injury was observed in either groups. ConclusionsIn the treatment of thoracolumbar compression fractures, percutaneous short-segment pedicle screws fixation without intermediate screws in the 4-screw construct may obtain the same clinical effect as that in the 6-screw construct.

24. Successful treatment of anal intraepithelial neoplasia by CO2 laser in a sexual health service

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 581
Author(s):  
Jenny McCloskey ◽  
Janelle Hall ◽  
Michael Phillips ◽  
Cecily Metcalf
Keyword(s):  
High Resolution ◽  
Co2 Laser ◽  
Preliminary Analysis ◽  
Intraepithelial Neoplasia ◽  
Anal Intraepithelial Neoplasia ◽  
Patient Demographics ◽  
Sexual Health Service ◽  
Before And After ◽  
Anal Disease

Background Treatments for anal intraepithelial neoplasia (AIN) are still being established. Methods: An audit of patients referred for treatment of anal disease by CO2 laser at a Perth SHS was performed. Patient demographics including sex, sexual preference, age, and HIV status were documented. Anal cytology, histopathology, and HPV testing before and after treatment were reviewed in this preliminary analysis. Initial diagnosis of anal disease including AIN was made by high-resolution anoscopy (HRA) and by histological examination. Patients were then referred for treatment. Six-monthly HRA review occurred after treatment and the original site of HGAIN was biopsied. Results: Preliminary analysis of 28 patients included 16 patients with AIN 2 and 12 with AIN 3. After laser treatment, 7 patients had no AIN, 3 had AIN 1, 10 had AIN 2 and 4 had AIN 3, indicating successful reduction in AIN status (Pearson χ2 = 15.2, P = 0.002). The incidence of AIN decreased over the 18 months of follow-up. Conclusions: Studies of CO2 laser ablation of the anal canal are ongoing and need further study. Table 1. High-resolution anoscopy follow up Rx, treatment

scholarly journals The effect of capped biparametric magnetic resonance imaging slots on weekly prostate cancer imaging workload

2020 ◽  
Vol 93 (1108) ◽  
pp. 20190929 ◽  
Author(s):  
Nikita Sushentsev ◽  
Iztok Caglic ◽  
Evis Sala ◽  
Nadeem Shaida ◽  
Rhys A Slough ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Mean Absolute Deviation ◽  
Resonance Imaging ◽  
Absolute Deviation ◽  
Intergroup Comparison ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Objective: To introduce capped biparametric (bp) MRI slots for follow-up imaging of prostate cancer patients enrolled in active surveillance (AS) and evaluate the effect on weekly variation in the number of AS cases and total MRI workload. Methods: Three 20 min bpMRI AS slots on two separate days were introduced at Addenbrooke’s Hospital, Cambridge. The weekly numbers of total prostate MRIs and AS cases recorded 15 months before and after the change (Groups 1 and 2, respectively). An intergroup variation in the weekly scan numbers was assessed using the coefficient of variance (CV) and mean absolute deviation; the Mann–Whitney U test was used for an intergroup comparison of the latter. Results: In AS patients, a shift from considerable to moderate variation in weekly scan numbers was observed between the two groups (CV, 51.7 and 26.8%, respectively); mean absolute deviation of AS scans also demonstrated a significant decrease in Group 2 (1.28 vs 2.58 in Group 1; p < 0.001). No significant changes in the variation in total prostate MRIs were observed, despite a 10% increased workload in Group 2. Conclusion: A significant reduction in weekly variation of AS cases was demonstrated following the introduction of capped bpMRI slots, which can be used for more accurate long-term planning of MRI workload. Advances in knowledge: The paper illustrates the potential of introducing capped AS MRI slots using a bp protocol to reduce weekly variation in demand and allow for optimising workflow, which will be increasingly important as the demands on radiology departments increase worldwide.

scholarly journals Anterior versus posterior surgical approach for lumbosacral tuberculosis

2018 ◽  
Vol 46 (7) ◽  
pp. 2569-2577 ◽  
Author(s):  
Bolong Zheng ◽  
Dingjun Hao ◽  
Hua Guo ◽  
Baorong He
Keyword(s):  
Cobb Angle ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Operation Time ◽  
Analog Scale ◽  
Loss Of Correction ◽  
Pain Scores ◽  
Angle Correction ◽  
Before And After

Objective To compare two different approaches for the treatment of lumbosacral tuberculosis. Patients and Methods In total, 115 patients who were surgically treated in our department from July 2010 to July 2014 were included in this retrospective study. They were divided into the anterior and posterior approach groups. Intraoperative hemorrhage; the surgery time; the Cobb angle preoperatively, postoperatively, and at the follow-up visit (2 years postoperatively); visual analog scale (VAS) pain scores before and after surgery; and Oswestry Disability Index (ODI) scores before and after surgery were compared between the two groups. Results The Cobb angle and VAS and ODI scores were significantly improved in both groups after surgery. Significant differences were found in the operation time, intraoperative hemorrhage, Cobb angle correction, and loss of correction at the last follow-up. No significant differences were found in the VAS and ODI scores between the groups. Conclusions The posterior approach is superior to the anterior approach with respect to the surgery time, intraoperative hemorrhage, and Cobb angle postoperatively and at the last follow-up. When both approaches can be carried out for a patient with lumbosacral tuberculosis, the posterior approach should be favored over the anterior approach.

scholarly journals Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

2014 ◽  
Vol 8 (9-10) ◽  
pp. 595 ◽  
Author(s):  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Aslan Demir ◽  
Ramazan Kocaaslan ◽  
Fatih Altunrende
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Statistical Difference ◽  
Preoperative Evaluation ◽  
Operation Time ◽  
Maximum Flow ◽  
Prostatic Hyperplasia ◽  
Group 2 ◽  
Hemoglobin Drop ◽  
Group 1

Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.

scholarly journals The Effect of Manual Therapy and Stabilizing Exercises on Forward Head and Rounded Shoulder Postures: a six-week intervention with a one-month follow-up study (Preprint)

2017 ◽  
Author(s):  
Kiana Fatholahnezhad ◽  
Amir Letafatkar ◽  
Malihe Hadadnezhad
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Post Intervention ◽  
Before And After ◽  
Group 2 ◽  
And Function ◽  
Group 1

BACKGROUND forward head and round shoulder posture is believed to alter scapular kinematics and muscle activity placing increased stress on the shoulder, leading to shoulder pain and dysfunction. OBJECTIVE The purpose of this study was to evaluate the effect of a six-week combined treatment consisting of manual therapy and stabilizing exercises, with a one-month follow-up, on neck pain with forward head and rounded shoulder postures. METHODS A total of 60 women aged 32-42 years of age with neck pain, and forward head and rounded shoulder postures were randomized into three groups: group 1 performed stabilizing exercises and received manual therapy (n=20), group 2 performed stabilizing exercises (n=20), and group 3 (control group) performed home exercises (n=20) over six weeks.The follow-up time was one month after the post test. The craniocervical and rounded shoulder angles, pain, and function were measured before and after six-week interventions, and a one-month follow- up. RESULTS The results showed significant positive changes within the experimental groupsin all variables, but there were minor changes in the control group in all variables before and after the intervention. Also, there were significant function and pain improvement in the experimental group 1 comparing to group 2. There were no differences between post intervention and one-month follow-up on posture and function in the experimental groups. CONCLUSIONS These findings suggest that both interventions were significantly effective for reducing neck pain, and improving function and posture in patients with chronic neck pain, and forward head and rounded shoulder postures. However, the improvement in function and pain was more effective in group 1 than those of group 2 suggesting that manual therapy can be used as a supplement method to the stabilizing intervention in the treatment of neck pain. More research is needed to confirm the result of this study.

Orbitozygomatic Craniotomy via an Eyebrow Incision: Management of the Opened Frontal Sinus

2020 ◽  
Author(s):  
David R. Peters ◽  
Caitlin Payne ◽  
Scott D. Wait
Keyword(s):  
Frontal Sinus ◽  
Analysis Data ◽  
Csf Leak ◽  
Invasive Approach ◽  
Perioperative Morbidity ◽  
Patient Demographics ◽  
Eyebrow Incision ◽  
Csf Leaks

Abstract Background The eyebrow orbitozygomatic craniotomy is a minimally invasive approach that can access a wide variety of lesions. Unintentional breach of the frontal sinus frequently occurs and has been cited as a reason to avoid this approach. Lack of access to a large pericranial graft and the inability to completely cranialize the sinus requires alternate techniques of sinus repair. We describe a technique for repairing an opened frontal sinus and retrospectively reviewed complications related to this approach. Methods All patients, who underwent an orbitozygomatic craniotomy via an eyebrow incision by a single surgeon from August 1, 2012 to August 31, 2018, were included in this retrospective analysis. Data were collected on patient demographics, pathology treated, operative details, and perioperative morbidity. Follow-up ranged from 6 weeks to 6 years. Results Total 50 patients with a wide variety of pathologies underwent analysis. Frontal sinus breach occurred in 21 patients. All were repaired by the described technique. One patient (ruptured aneurysm) had a suspected cerebrospinal fluid (CSF) leak postoperatively that resolved without any additional intervention. One patient developed a pneumomeningocele 4 years postoperatively that required reoperation. No patient suffered any infection or delayed CSF leak. Conclusion Breach of the frontal sinus is common during eyebrow craniotomies. Despite reduced options for local repair, these patients have experienced no CSF leaks requiring intervention and no infections in our series. Long-term mucocele risk is not reliably determined with our length of follow-up. Breach of the frontal sinus is not a contraindication to the eyebrow approach.

scholarly journals Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 95 (9) ◽  
pp. e1257-e1266 ◽  
Author(s):  
Salvatore C. Rametta ◽  
Sara E. Fridinger ◽  
Alexander K. Gonzalez ◽  
Julie Xian ◽  
Peter D. Galer ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Minority Groups ◽  
Child Neurology ◽  
Patient Demographics ◽  
Retrospective Comparison ◽  
Before And After ◽  
Future Care ◽  
Icd 10 ◽  
Audio Video

ObjectiveTo assess the rapid implementation of child neurology telehealth outpatient care with the onset of the coronavirus disease 2019 (COVID-19) pandemic in March 2020.MethodsThis was a cohort study with retrospective comparison of 14,780 in-person encounters and 2,589 telehealth encounters, including 2,093 audio-video telemedicine and 496 scheduled telephone encounters, between October 1, 2019 and April 24, 2020. We compared in-person and telehealth encounters for patient demographics and diagnoses. For audio-video telemedicine encounters, we analyzed questionnaire responses addressing provider experience, follow-up plans, technical quality, need for in-person assessment, and parent/caregiver satisfaction. We performed manual reviews of encounters flagged as concerning by providers.ResultsThere were no differences in patient age and major ICD-10 codes before and after transition. Clinicians considered telemedicine satisfactory in 93% (1,200 of 1,286) of encounters and suggested telemedicine as a component for follow-up care in 89% (1,144 of 1,286) of encounters. Technical challenges were reported in 40% (519 of 1,314) of encounters. In-person assessment was considered warranted after 5% (65 of 1,285) of encounters. Patients/caregivers indicated interest in telemedicine for future care in 86% (187 of 217) of encounters. Participation in telemedicine encounters compared to telephone encounters was less frequent among patients in racial or ethnic minority groups.ConclusionsWe effectively converted most of our outpatient care to telehealth encounters, including mostly audio-video telemedicine encounters. Providers rated the vast majority of telemedicine encounters to be satisfactory, and only a small proportion of encounters required short-term in-person follow-up. These findings suggest that telemedicine is feasible and effective for a large proportion of child neurology care. Additional strategies are needed to ensure equitable telemedicine use.

Improving Patient Education of Facial Fractures Using 3-Dimensional Computed Tomography

2021 ◽  
pp. 019459982110285
Author(s):  
Peter Wickwire ◽  
Sukhraj Kahlon ◽  
Soroush Kazemi ◽  
Travis Tollefson ◽  
Toby Steele ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Patient Education ◽  
Self Assessment ◽  
3 Dimensional ◽  
Complex Fracture ◽  
Zygomaticomaxillary Complex Fracture ◽  
Assessment Survey ◽  
Group 2 ◽  
Zygomaticomaxillary Complex ◽  
Group 1

Objective Advances in 3-dimensional modeling have revolutionized presurgical planning for maxillofacial reconstruction, yet little is known about how this technology may affect patient education. This study was designed to evaluate the efficacy of 2-dimensional computed tomography versus 3-dimensional computed tomography for patient education in maxillofacial reconstruction. Study Design Crossover study. Setting General otolaryngology outpatients from a tertiary referral center were recruited. Methods A single computed tomography data set of a zygomaticomaxillary complex fracture was used to generate 2 educational video tutorials: one in a 2-dimensional format and one in a 3-dimensional format. The tutorials were embedded into the QualtricsXM platform. Participants were randomly assigned into 2 groups. Group 1 viewed the 2-dimensional tutorial, took a self-assessment survey, took an information recall survey, viewed the 3-dimensional tutorial, and finally took a tutorial comparison survey. Group 2 followed the same sequence but viewed the 3-dimensional tutorial followed by the 2-dimensional tutorial. Results Group 2 participants (viewing the 3-dimensional tutorial first) scored better on the self-assessment survey than their counterparts in group 1 did ( P = .023). Group 2 also scored better on the recall survey ( P = .042). Of all participants, 61% preferred the 3-dimensional tutorial, and 31% preferred the use of both tutorials together in the comparison survey. Conclusions Three-dimensional patient educational tutorial regarding a zygomaticomaxillary complex fracture resulted in better knowledge retention and was preferred over the 2-dimensional format.

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