Incidence and Radiological Findings of Incidental Sinus Opacifications in Patients Undergoing Septoplasty or Septorhinoplasty

2019 ◽  
Vol 129 (2) ◽  
pp. 122-127 ◽  
Author(s):  
Sung Hee Kim ◽  
Jin Seok Oh ◽  
Yong Ju Jang
Keyword(s):  
Medical Center ◽  
Ct Images ◽  
Radiological Findings ◽  
Sinus Disease ◽  
Retention Cyst ◽  
Preoperative Ct ◽  
Asan Medical ◽  
Anatomical Detail ◽  
Paranasal Sinus Disease ◽  
Mucosal Thickening

Objectives: Although the routine use of computed tomography (CT) is controversial, it is employed in the preoperative screening of patients undergoing septoplasty or septorhinoplasty. The aim of this study was to evaluate the incidence and radiological characteristics of incidentally found sinus pathologies on screening CT in patients who underwent elective septoplasty or septorhinoplasty. Methods: We retrospectively reviewed the patients who underwent septoplasty and septorhinoplasty performed by a single surgeon (Y.J.J.) at Asan Medical Center between January 2016 and December 2017. CT images of 372 patients who had agreed to undergo preoperative CT were reviewed to determine the location and extent of incidental sinus opacifications. Results: Of the 372 patients, 107 (28.8%) showed incidental sinus lesions on CT images. Opacifications were mainly found in the maxillary sinus (73, 68.2%), followed by the ethmoid (34, 31.8%), sphenoid (10, 9.3%), and frontal (3, 2.8%) sinuses. The most common sinus lesion was retention cyst (55, 51.4%), and the second most common one was opacification and mucosal thickening (46, 43%). Other lesions such as osteoma (3, 2.8%), dental cyst (2, 1.9%), and mucocele (1, 0.9%) were rarely found. Conclusions: In patients undergoing septoplasty or septorhinoplasty, the incidence of incidental sinus lesions was approximately 28.8% (107/372). This results indicate that preoperative CT in patients undergoing septoplasty or septorhinoplasty might be helpful to surgeons not only for better understanding the anatomical detail but also for detecting hidden paranasal sinus disease.

Pre- and Postoperative Imaging Analysis for Frontal Sinus Disease following Conservative Partial Middle Turbinate Resection

1998 ◽  
Vol 77 (4) ◽  
pp. 326-334 ◽  
Author(s):  
Iyad S. Saidi ◽  
John F. Biedlingmaier ◽  
Michael I. Rothman
Keyword(s):  
Frontal Sinus ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Mr Images ◽  
Sinus Disease ◽  
Frontal Recess ◽  
Postoperative Mri ◽  
Preoperative Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Mucosal Thickening

The prudence of partial or complete middle turbinate resection during endoscopic sinus surgery (ESS) is controversial. The greatest concern regarding partial resection relates to the effect on the frontal recess and the development of frontal sinus disease. The purpose of this study was to radiographically evaluate the frontal sinus in patients who had undergone ESS with partial conservative middle turbinate resection. We reviewed the charts and operative records from 195 consecutive cases of ESS performed by a single surgeon (JFB) over a two-year period. Thirty-three of 117 patients who had undergone ESS with conservative partial middle turbinate resection without frontal recess exploration agreed to return for magnetic resonance imaging (MRI) of their sinuses. The preoperative computed tomography (CT) scans and postoperative MR images were reviewed and graded (1–3) by a single neuroradiologist. Significant frontal sinus disease (grades 2 and 3) was seen in 15 of 52 sides preoperatively (29%), and in 14 sides postoperatively (27%). During the postoperative MRI studies, only six frontal sinus sides demonstrated minimal mucosal thickening (grade 1) which had not been apparent on preoperative CT. This radiographic analysis suggests that conservative partial middle turbinate resection during ESS does not adversely affect the frontal sinus. We believe that the surgical technique employed when resecting the middle turbinate, and the avoidance of unnecessary dissection in the recess are both important factors in preventing the development of frontal sinus disease following ESS.

A Comparative Study of Endoscopic Finding and Radiological Appearance in Paranasal Sinus Disease

2018 ◽  
Vol 2 (S1) ◽  
pp. e000128
Author(s):  
Anjani Agarwal ◽  
Alpesh Fefar ◽  
Manish Mehta
Keyword(s):  
Ct Scan ◽  
Paranasal Sinus ◽  
Uncinate Process ◽  
Nasal Endoscopy ◽  
High Association ◽  
Sinus Disease ◽  
Radiological Appearance ◽  
Highly Sensitive ◽  
Operative Findings ◽  
Paranasal Sinus Disease

Aims and Objectives: The study is carried out with an objective to compare the diagnostic nasal endoscopic findings and radiological appearance in patients with paranasal sinus disease. Methods: 50 cases of chronic sinusitis not responding to routine medical line of treatment were selected and operated after being thoroughly investigated by means of nasal endoscopy and CT scan.  Results: Out of 50 cases, 35 underwent bilateral surgery and 15 underwent unilateral surgery, so a total of 85 procedures were carried out. Findings of both the CT scan as well as diagnostic nasal endoscopy were compared to each other and ultimately correlated with operative findings.  Conclusion: In our study, a high association is found between both the modalities of investigation i.e CT scan and diagnostic nasal endoscopy with one scoring over the other in different parameters. Diagnostic nasal endoscopy is found to be highly sensitive investigatory modality for parameters like frontal recess, spheno-ethmoid recess and hiatus semilunaris, where as CT scan is found to be highly sensitive for parameters like maxillary sinus, uncinate process and posterior ethmoids. So, a case of sinus disease should be diagnosed as early as possible using both these modalities as together they complement each other. Early diagnosis and effective management cures the pathology and prevents disastrous complications.  

Umbilical Fascial Defects are Common and Predict Trocar Site Hernias After Laparoscopic Appendectomy

2021 ◽  
pp. 000313482199506
Author(s):  
Steven M. Hernandez ◽  
Elizabeth A. Kiselak ◽  
Tania Zielonka ◽  
Scarlett Tucker ◽  
Melissa Blatt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Appendectomy ◽  
Medical Center ◽  
Area Under The Curve ◽  
Demographic Information ◽  
Fascial Defect ◽  
Trocar Site ◽  
Trocar Site Hernia ◽  
Preoperative Ct ◽  
Tomography Scan

Introduction Investigations have demonstrated that trocar site hernia (TSH) is an under-appreciated complication of laparoscopic surgery, occurring in as many as 31%. We determined the incidence of fascial defects prior to laparoscopic appendectomy and its impact relative to other risk factors upon the development of TSH. Methods TSH was defined as a fascial separation of ≥ 1 cm in the abdominal wall umbilical region on abdominal computerized tomography scan (CT) following laparoscopic appendectomy. Patients admitted to our medical center who had both a preoperative CT and postoperative CT for any reason (greater than 30 days after surgery) were reviewed for the presence of TSH from May 2010 to December 2018. CT scans were measured for fascial defects, while investigators were blinded to film timing (preoperative or postoperative) and patient identity. Demographic information was collected. Results 241 patients undergoing laparoscopic appendectomy had both preoperative and late postoperative CT. TSH was identified in 49 (20.3%) patients. Mean preoperative fascial gap was 3.3 ± 4.3 mm in those not developing a postoperative hernia versus 14.8 ± 7.3 mm in those with a postoperative hernia ( P < .0001). Preoperative fascial defect on CT was predictive of TSH ( P < .001, OR = 1.44), with an Area Under the Curve (AUC) of .921 (95%CI: .88–.92). Other major risk factors for TSH were: age greater than 59 years ( P < .031, OR = 2.48); and obesity, BMI > 30 ( P < .012, OR = 2.14). Conclusions The incidence of trocar site hernia was one in five following laparoscopic appendectomy. The presence of a pre-existing fascial defect, advanced age, and obesity were strong predictors for the development of trocar site hernia.

scholarly journals Influence of Postoperative Changes in Sarcopenia on Long-Term Survival in Non-Metastatic Colorectal Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2410
Author(s):  
Chungyeop Lee ◽  
In-Ja Park ◽  
Kyung-Won Kim ◽  
Yongbin Shin ◽  
Seok-Byung Lim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Medical Center ◽  
The Body ◽  
Term Survival ◽  
Postoperative Changes ◽  
Asan Medical ◽  
Colorectal Cancer Patients

The effect of perioperative sarcopenic changes on prognosis remains unclear. We conducted a retrospective cohort study with 2333 non-metastatic colorectal cancer patients treated between January 2009 and December 2012 at the Asan Medical Center. The body composition at diagnosis was measured via abdominopelvic computed tomography (CT) using Asan-J software. Patients underwent CT scans preoperatively, as well as at 6 months–1 year and 2–3 years postoperatively. The primary outcome was the association between perioperative sarcopenic changes and survival. According to sarcopenic criteria, 1155 (49.5%), 890 (38.2%), and 893 (38.3%) patients had sarcopenia preoperatively, 6 months–1 year, and 2–3 years postoperatively, respectively. The 5-year overall survival (OS) (95.8% vs. 92.1%, hazard ratio (HR) = 2.234, p < 0.001) and 5-year recurrence-free survival (RFS) (93.2% vs. 86.2%, HR = 2.251, p < 0.001) rates were significantly lower in patients with preoperative sarcopenia. Both OS and RFS were lower in patients with persistent sarcopenia 2–3 years postoperatively than in those who recovered (OS: 96.2% vs. 90.2%, p = 0.001; RFS: 91.1% vs. 83.9%, p = 0.002). In multivariate analysis, postoperative sarcopenia was confirmed as an independent factor associated with decreased OS and RFS. Pre- and postoperative sarcopenia and changes in the condition during surveillance were associated with oncological outcomes.

Urine β-2-glycoprotein 1 as a biomarker for diagnosis of systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Jung Sun Lee ◽  
Eun-Ju Lee ◽  
Jeonghun Yeom ◽  
Ji Seon Oh ◽  
Seokchan Hong ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Medical Center ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Urine Samples ◽  
Enzyme Linked Immunosorbent Assay ◽  
Systemic Lupus ◽  
Asan Medical

Objective The need for a biomarker with robust sensitivity and specificity in diagnosing systemic lupus erythematosus (SLE) remains unmet. Compared with blood samples, urine samples are more easily collected; thus, we aimed to identify such a biomarker based on urinary proteomics which could distinguish patients with SLE from healthy controls (HCs). Methods Urine samples were collected from 76 SLE patients who visited rheumatology clinic in 2019 at Asan medical center and from 25 HCs. Urine proteins were analyzed using sequential windowed acquisition of all theoretical fragment ion spectra-mass spectrometry, and the candidate marker was confirmed by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic curve analysis was used to determine the diagnostic value of the candidate biomarker. Results Of 1157 proteins quantified, 153 were differentially expressed in urine samples from HCs. Among them were previously known markers including α-1-acid glycoprotein 1, α-2-HS-glycoprotein, ceruloplasmin, and prostaglandin-H2 D-isomerase. Moreover, the amount of β-2 glycoprotein (APOH) was increased in the urine of patients with SLE. The ELISA results also showed the level of urine APOH was higher in patients with SLE than in HCs and patients with rheumatoid arthritis. Moreover, the level was not different between SLE patients with and without nephritis. The urine APOH had an area under the curve value of 0.946 at a cut-off value of 228.53 ng/mg (sensitivity 91.5%, specificity 92.0%) for the diagnosis of SLE. Conclusion The results indicate that the urine APOH level can be an appropriate screening tool in a clinical setting when SLE is suspected.

Limited-slice CT in the evaluation of paranasal sinus disease in children.

1991 ◽  
Vol 156 (2) ◽  
pp. 367-369 ◽  
Author(s):  
G W Gross ◽  
S J McGeady ◽  
T Kerut ◽  
S M Ehrlich
Keyword(s):  
Paranasal Sinus ◽  
Sinus Disease ◽  
Paranasal Sinus Disease

Pregnancy Outcomes Using Assisted Reproductive Technology After Fertility-Preserving Therapy in Patients With Endometrial Adenocarcinoma or Atypical Complex Hyperplasia

2009 ◽  
Vol 19 (1) ◽  
pp. 147-151 ◽  
Author(s):  
Aera R. Han ◽  
Yong-Soon Kwon ◽  
D. Y. Kim ◽  
J. H. Kim ◽  
Y. M. Kim ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Assisted Reproductive Technology ◽  
Intrauterine Insemination ◽  
Medical Center ◽  
Endometrial Adenocarcinoma ◽  
Controlled Ovarian Hyperstimulation ◽  
Reproductive Technology ◽  
Vitro Fertilization ◽  
Asan Medical

Objectives:To evaluate the outcomes of pregnancy in young women (<40 years old) with early endometrial cancer or atypical complex hyperplasia who were treated by conservative management followed by assisted reproductive technology (ART).Materials and Methods:Medical charts of 11 patients treated from January 1997 to October 2007 at Asan Medical Center were retrospectively reviewed. These patients had all been treated with progestin and serial dilatation and curettage as primary fertility-preserving therapies.Results:After pathological remission of disease, 10 patients tried to become pregnant by ART, 4 by in vitro fertilization and embryo transfer, and 6 by controlled ovarian hyperstimulation, with or without intrauterine insemination. Eight women had intrauterine pregnancies, and 6 patients had live births. Patients have been followed up for 9 to 51 months (mean, 21 months) after delivery, with no evidence of tumor recurrence.Conclusions:Fertility-preserving therapy followed by ART can be a good option in well-selected patients with early endometrial cancer who want to become pregnant.

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