scholarly journals Repair of the Protruding Lobule

2019 ◽  
Vol 129 (1) ◽  
pp. 63-69
Author(s):  
Hermann Raunig ◽  
Grant S. Hamilton
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Blood Supply ◽  
Surgical Procedures ◽  
Successful Intervention ◽  
Small Areas ◽  
Patient Cohort ◽  
Protruding Ear

Background: In this paper, the author describes a novel step-by-step setback procedure for correcting protruding lobules; the success of correcting protruding lobules depends on the nature and severity of the auricular lobule deformity. Although the auricular lobules occupy small areas on either side of the head, protruding or misshapen lobules exert a significant and sometimes exaggerated disfiguring influence on the otherwise aesthetically pleasing appearance of the ears. Because the lobule is a soft structure without a cartilage skeleton, the correction of a protruding ear and lobule is always a challenge. Methods: Protruding lobule abnormalities stem from deformities of the cauda helicis (cartilaginous helical tail) of the auricular lobule, soft tissue, and/or a shortage of anterior skin; however, the abnormalities are usually a combination of all of the above. Therefore, surgical procedures should address all of the causes of lobule deformity and preserve as much tissue and blood supply as possible. Achieving a successful intervention depends on reducing the tension that affects the entire lobule. Results: This is a retrospective analysis of 660 patients who had otoplasty performed by the first author between January 2010 and December 2017. Correction of the ear lobule was needed in 398 (60.3%) patients. Of these, 44.6% patients were male, 55.4% female and the average age was 9 years (range 4-18 years). In this patient cohort, 356 (89.4%) required bilateral and 42 (10.5%) unilateral ear lobule correction. Standardized pre- and postoperative images were recorded for each patient. Conclusion: The goal of a setback procedure is a natural and harmonious auricular lobule appearance that is achieved through simple, optimal surgery that addresses all of the features of the auricular anatomy.

scholarly journals Standardized Forearm Angiography Increases Procedural Success Rates of Coronary Angiography and PCI: A Retrospective Analysis of an All-Comers Patient Cohort

2022 ◽  
Author(s):  
Tobias Roeschl ◽  
Anas Jano ◽  
Franziska Fochler ◽  
Lars S. Maier ◽  
Mona M. Grewe ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Retrospective Analysis ◽  
Blood Supply ◽  
Vascular Complications ◽  
Success Rates ◽  
Arterial Spasm ◽  
Patient Cohort ◽  
Transradial Access ◽  
Coronary Procedures ◽  
Procedural Success

Abstract Background: There is a consensus, that transradial-access (TRA) for coronary procedures should be preferred over transfemoral-access (TFA). Previously, forearm-artery-angiography was mainly performed when difficulties during the advancement of the guidewire were encountered. We explored the implication of a standardized forearm-angiography (SFA) on procedural success rates of TRA.Methods: 1191 consecutive cases were assessed retrospectively. Primary TFA rates, crossover to TFA, reasons for forearm-artery-access (FAA) failure, the prevalence of kinking at the level of the forearm and the occurrence of vascular complications were analyzed.Results: Primary FAA access was attempted in 97.9%. Crossover to TFA after a primary or secondary FAA attempt was necessary in 2.8%. Severe kinking was the most frequent cause of FAA failure and occurred in 3.0%. A second or third FAA attempt to avoid TFA was successful in 81%. Severe kinking at the level of the forearm was reported in 1.8%.Conclusion:This is the first study to provide detailed success rates of a primary FAA strategy combined with SFA. While severe kinking proved to be a rare but relevant challenge for FAA success, the prevalence of arterial spasm was marginal. Multiple attempts of FAA to avoid TFA might be safe possibly due to collateral blood supply.

scholarly journals Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

2021 ◽  
pp. 112067212110024
Author(s):  
Roberto dell’Omo ◽  
Mariaelena Filippelli ◽  
Gianni Virgili ◽  
Francesco Bandello ◽  
Giuseppe Querques ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Retinal Detachment ◽  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Public Transportation ◽  
Rhegmatogenous Retinal Detachment ◽  
Intravitreal Injections ◽  
P Value ◽  
Academic Hospitals ◽  
Rate Ratios

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

scholarly journals True Kinematic Alignment Is Applicable in 44% of Patients Applying Restrictive Indication Criteria—A Retrospective Analysis of 111 TKA Using Robotic Assistance

2021 ◽  
Vol 11 (7) ◽  
pp. 662
Author(s):  
Kim Huber ◽  
Bernhard Christen ◽  
Sarah Calliess ◽  
Tilman Calliess
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Patient Specific ◽  
Kinematic Alignment ◽  
Postoperative Phase ◽  
Robotic Assistance ◽  
Component Position ◽  
Joint Stability ◽  
Robotic Assisted ◽  
Primary Tkas

Introduction: Image-based robotic assistance appears to be a promising tool for individualizing alignment in total knee arthroplasty (TKA). The patient-specific model of the knee enables a preoperative 3D planning of component position. Adjustments to the individual soft-tissue situation can be done intraoperatively. Based on this, we have established a standardized workflow to implement the idea of kinematic alignment (KA) for robotic-assisted TKA. In addition, we have defined limits for its use. If these limits are reached, we switch to a restricted KA (rKA). The aim of the study was to evaluate (1) in what percentage of patients a true KA or an rKA is applicable, (2) whether there were differences regarding knee phenotypes, and (3) what the differences of philosophies in terms of component position, joint stability, and early patient outcome were. Methods: The study included a retrospective analysis of 111 robotic-assisted primary TKAs. Based on preoperative long leg standing radiographs, the patients were categorized into a varus, valgus, or neutral subgroup. Initially, all patients were planned for KA TKA. When the defined safe zone had been exceeded, adjustments to an rKA were made. Intraoperatively, the alignment of the components and joint gaps were recorded by robotic software. Results and conclusion: With our indication for TKA and the defined boundaries, “only” 44% of the patients were suitable for a true KA with no adjustments or soft tissue releases. In the varus group, it was about 70%, whereas it was 0% in the valgus group and 25% in the neutral alignment group. Thus, significant differences with regard to knee morphotypes were evident. In the KA group, a more physiological knee balance reconstructing the trapezoidal flexion gap (+2 mm on average laterally) was seen as well as a closer reconstruction of the surface anatomy and joint line in all dimensions compared to rKA. This resulted in a higher improvement in the collected outcome scores in favor of KA in the very early postoperative phase.

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

2021 ◽  
pp. 105566562110076
Author(s):  
Maria Costanza Meazzini ◽  
Noah Cohen ◽  
Valeria Marinella Augusta Battista ◽  
Cristina Incorvati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Efficient Method ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Younger Patients ◽  
Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

Soft-tissue changes associated with different surgical procedures for treating class III patients

2014 ◽  
Vol 75 (4) ◽  
pp. 299-307 ◽  
Author(s):  
M. Ghassemi ◽  
A. Jamilian ◽  
J.R. Becker ◽  
A. Modabber ◽  
U. Fritz ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Class Iii ◽  
Tissue Changes ◽  
Soft Tissue Changes

scholarly journals Incidence of Horner syndrome associated with neuroblastic disease

2020 ◽  
Author(s):  
Katarzyna Kuchalska ◽  
Monika Barełkowska ◽  
Katarzyna Derwich ◽  
Katarzyna Jończyk-Potoczna ◽  
Anna Gotz-Więckowska
Keyword(s):  
Adrenal Gland ◽  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Pediatric Oncology ◽  
Surgical Procedure ◽  
Pediatric Patients ◽  
Study Group ◽  
Horner Syndrome ◽  
Neuroblastic Tumor ◽  
Frequent Localization

Abstract Purpose Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL. Methods A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor. Results Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old. Conclusion Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment.

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