Mucosal Bridge Reconstruction: A Novel Approach for the Vocal Fold Mucosal Bridge

2022 ◽  
pp. 000348942110532
Author(s):  
Engin Başer ◽  
İsmail İlter Denizoğlu
Keyword(s):  
Free Surface ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Subjective Evaluation ◽  
Subjective Assessment ◽  
Patient Age ◽  
Duration Of Symptoms ◽  
Novel Approach ◽  
Patient Âgé ◽  
Bridge Reconstruction

Introduction: Mucosal Bridges (MBs) are defined as benign connective tissue abnormalities of unclear etiology that extend over the free surface of the vocal fold, are attached to the front and back of the vocal fold but are not attached to its free surface, and are histologically covered by stratified squamous epithelium. In order to overcome these drawbacks, we aimed to retrospectively evaluate and present the preoperative and postoperative results of patients with MB, who were applied the method we call “Mucosal Bridge Reconstruction” (MBR), which we apply as suturing rather than resection of the MB. Methods: Between January 2016 and February 2020, 5 patients who applied to the voice clinic due to dysphonia and were diagnosed with MB via laryngostroboscopic examination and direct laryngoscopy under general anesthesia were included in the study. Dr Speech software was used for acoustic analysis; mean fundamental frequency (fo), jitter %, shimmer %, and noise to harmonic ratio (NHR) were objectively measured and recorded. Voice Handicap Index-10 (VHI-10) was used for positive self-reporting of the severity of vocal symptoms. GRBAS scale (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) was also used (by the same clinician) for clinic subjective evaluation. Results: Patient age ranged from 33 to 55 years and mean patient age was 42 years. Mean duration of symptoms was 22 months (range 16-30). Mean postoperative follow-up time was 14 months (range 6-24). Unilateral MB was observed in all patients (2 left, 3 right). There was a significant improvement in objective and subjective assessment methods in all our patients after surgery. Conclusions: According to the results of our few patients, MBR offers a physiological and anatomical approach to the treatment of patients with MB. The outcomes of delicate microlaryngeal surgery are promising.

Association of proliferative activity and size in acoustic neuroma: implications for timing of surgery

2003 ◽  
Vol 98 (4) ◽  
pp. 807-811 ◽  
Author(s):  
Anan Bedavanija ◽  
Jürgen Brieger ◽  
Hans-Anton Lehr ◽  
Jan Maurer ◽  
Wolf J. Mann
Keyword(s):  
Acoustic Neuroma ◽  
Growth Rates ◽  
Tumor Size ◽  
Proliferative Activity ◽  
Ki 67 ◽  
Patient Age ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Patient Âgé ◽  
Fine Print

Object. Acoustic neuroma is the most frequent benign tumor of the cerebellopontine angle, and surgery is still the most common form of treatment. To gain better insight into the dysregulated mechanisms causing growth of acoustic neuroma, the authors studied the proliferative activity of 34 consecutive samples by analyzing immunohistochemical staining with Ki-67 and proliferating cell nuclear antigen (PCNA), and apoptosis based on the terminal deoxynucleotidyl transferase—mediated deoxyuridine triphosphate nick-end labeling. Data from these analyses were correlated with clinical parameters (that is, tumor size, duration of symptoms, and patient age). Methods. Apoptotic cells were found in none of the tumors. Proliferation measured on staining with Ki-67 and PCNA correlated with tumor size, but not with patient age or duration of symptoms. The authors demonstrated that tumors 18 mm or smaller in diameter have lower proliferation indices and growth rates, compared with tumors larger than 18 mm with high proliferative indices and growth rates. Additionally, they observed that these more aggressive, larger tumors occur mostly in patients younger than 50 years of age. Conclusions. Patients with tumors larger than 18 mm in diameter and who are younger than 50 years of age sustain an enhanced risk for fast-growing tumors because of these lesions' enhanced proliferative activity. For these patients the authors recommend active therapy.

Paget's disease of the vulva: clinicopathologic study of type 1 cases treated at a single institution

2006 ◽  
Vol 16 (3) ◽  
pp. 1212-1215 ◽  
Author(s):  
H. Niikura ◽  
H. Yoshida ◽  
K. Ito ◽  
T. Takano ◽  
H. Watanabe ◽  
...  
Keyword(s):  
Paget’S Disease ◽  
Paget's Disease ◽  
Careful Examination ◽  
Secondary Malignancy ◽  
Patient Age ◽  
Duration Of Symptoms ◽  
Patient Âgé ◽  
Mapping Biopsy

The aim of this study was to evaluate clinicopathologic characteristics of primary cutaneous Paget's disease of the vulva. Between 1986 and 2005, 22 patients with primary cutaneous Paget's disease of the vulva (type 1) were treated at Tohoku University Hospital. Medical records were reviewed for pathologic diagnosis, patient age, associated neoplasms, type(s) of eczema, symptom duration, treatment, surgical procedures, recurrence, and length of follow-up. Patient age ranged from 51 to 85 years (median 71.5 years). Median duration of symptoms was 24 months (range 2–60 months). Type 1a (intraepithelial) Paget's disease accounted for 18 patients, with 3 type 1b (invasive) cases and 1 type 1c (intraepithelial disease with underlying adenocarcinoma) case. Mean length of follow-up was 53.7 months, and median follow-up was 49 months (range 6–199 months). Only two patients had an associated internal malignancy: T-cell leukemia and breast cancer. Mapping biopsy was performed in 14 of the 18 type 1a cases. All patients were free of disease at the surgical margins and are alive without recurrence. The four patients with type 1b or 1c disease had lymph node metastases. Two has died of disease, and two are alive with no recurrence. The rate of secondary malignancy seems to be low in primary cutaneous Paget's disease of the vulva. Mapping biopsy with careful examination of characteristic skin surface may be useful for surgery of type 1a cases. Inguinal lymphadenectomy is recommended in cases with question of invasion or known underlying adenocarcinoma.

scholarly journals Prognostic Indices of Surgical Outcome in Cervical Spondylotic Myelopathy: A Clinical Prospective Study

2021 ◽  
Vol 9 (B) ◽  
pp. 438-443
Author(s):  
Ahmed A. Marei ◽  
Mohamed Reda Rady ◽  
Hazem Mostafa Kamal ◽  
William C. Welch ◽  
Mohamed A. Hafez
Keyword(s):  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
The Elderly ◽  
Significant Prognostic Factor ◽  
Mr Images ◽  
University Hospitals ◽  
Patient Age ◽  
Duration Of Symptoms ◽  
Patient Âgé ◽  
Prognostic Indices

BACKGROUND: One of the most common causes of spinal cord dysfunction is cervical spondylotic myelopathy (CSM) especially in the elderly. Prognostic indices can aid the surgeon preoperatively to detect the patients’ prognosis. AIM: The aim of the work is to better assess patients and to find possible indicators for post-operative improvement or deterioration in CSM patients. METHODS: Forty patients with multiple levels CSM, admitted and operated on in the Neurosurgery Department of Cairo University Hospitals, have been enrolled randomly in this study after fulfilling the criteria for CSM surgical intervention. The patient age, complaint duration, number of levels affected, signal intensity on T1-weighted and T2-weighted magnetic resonance (MR) images, Japan Orthopedic Association (JOA) scoring system, and Nurick’s score were evaluated before surgery and correlated with outcome after 1 year follow-up. RESULTS: About 80% of patients improved after operation with average pre- and post-operative JOA and Nurick scores about 11.23 and 3.12; 14.1 and 1.6, respectively. Patient age, sex, number of levels affected, and signal intensity on T1- weighted and T2-weighted MR images were not significantly associated with post-operative improvement, p > 0.05. However, the only significant prognostic factor was the duration of symptoms if less than 1 year with p < 0.05. CONCLUSION: Short complaint duration coupled with close intra-operative monitoring was directly correlated with good CMS operation outcome while age, sex, number of levels affected, presence of cord signal on MR imaging, and surgical approach appear to have no significant effect on outcome.

Indications for Repair of Full-Thickness Rotator Cuff Tears

2007 ◽  
Vol 35 (6) ◽  
pp. 1007-1016 ◽  
Author(s):  
Brian R. Wolf ◽  
Warren R. Dunn ◽  
Rick W. Wright
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Indications For Surgery ◽  
Full Thickness ◽  
Patient Age ◽  
Duration Of Symptoms ◽  
Multiple Factors ◽  
Patient Âgé ◽  
Cuff Repair

Rotator cuff repair surgery for full-thickness tears is common and accepted in orthopaedics today. Given that a significant number of people have asymptomatic rotator cuff tears, the indications for surgery are, however, somewhat unclear. Multiple factors such as duration of symptoms, acuity and size of the tear, patient age, and others require consideration and can influence the decision to perform surgery. This article reviews these variables and the indications for surgery to repair full-thickness rotator cuff tears.

Gestion orthopédique d’une ankylose de l’ATM chez l’enfant

2020 ◽  
Vol 54 (4) ◽  
pp. 407-418
Author(s):  
Pamela Villalon-Pooley ◽  
Camila Hernandez-Veliz ◽  
Maria Fernanda Pinto-Chavez ◽  
Pierre Bourdiol
Keyword(s):  
Patient Age ◽  
Patient Âgé

Parmi les fractures cranio-faciales, celles affectant le condyle mandibulaire font partie des fractures les plus souvent rencontrées chez le patient en âge pédiatrique. L’évolution sans traitement peut produire une ankylose temporo-mandibulaire entraînant troubles fonctionnels et asymétrie de la croissance cranio-faciale. Le traitement traditionnellement chirurgical est d’un pronostic généralement réservé. Dans cet article est présenté le cas d’un patient, âgé de quatre ans, atteint d’ankylose fibreuse de l’articulation temporo-mandibulaire gauche, suite probable d’une fracture du col du condyle non-diagnostiquée. La libération fonctionnelle de la fibro-ankylose articulaire a été l’objectif de la première étape thérapeutique. Celle-ci a été suivie, à l’âge de sept ans, d’une distraction articulaire obtenue au moyen de butées occlusales controlatérales disposées côté droit. Ceci a produit un ajustement de la croissance dento-alvéolaire assurant à la fois un rattrapage du déficit de croissance unilatéral de départ et une néoformation condylienne par remodelage de l’articulation temporo-mandibulaire gauche. Quatre années après la mise en route de la phase orthopédique initiale, la fonction articulaire restaurée et l’équilibre facial obtenu restent stables chez ce jeune patient

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Hämophilie-Zentrum Bonn 1980 – 2009

2011 ◽  
Vol 31 (S 01) ◽  
pp. S4-S10 ◽  
Author(s):  
I. Besmens ◽  
H.-H. Brackmann ◽  
J. Oldenburg
Keyword(s):  
Young Patients ◽  
Severe Form ◽  
Coagulation Disorder ◽  
Care Providers ◽  
Long Distance ◽  
Patient Age ◽  
Patient Âgé ◽  
Number Of Patients ◽  
Clotting Disorder ◽  
Regional Character

SummaryThe Bonn Haemophilia Care Center provides patient care on a superregional level. The centre’s large service area is, in part, due to the introduction of haemophilia home treatment and related to this the individualized prophylaxis in children and adults by Egli and Brack-mann in Bonn in the early 1970s, that represented a milestone in German haemophilia therapy. Epidemiologic patient data from the two selected time points, 1980 and 2009, are evaluated to illustrate the change in the composition of the patient clientele. In 1980 a total of 639 patients were treated at the Bonn Haemophilia Center. 529 patients exhibited a severe form and 110 a non-severe form of the respective clotting disorder. In 2009 the Bonn Haemophilia Center took care for a total of 837 patients. There were 445 patients who suffered from a severe form of the considered clotting disorder while 392 showed a non-severe course. The number of less severely affected patients has increased significantly in 2009. Patients in 1980 were predominantly suffering from a severe form and most had to travel more than 150 km from their homes to the treatment center. In 2009 the number of patients living a medium-long distance from the care provider has significantly increased while the number of patients living more than 150km from the center has decreased. Comparing 2009 to 1980 a growth of the center’s regional character becomes apparent, especially when patient age and severity of the coagulation disorder are taken into consideration. The regional character was more strongly pronounced with milder disease severity and lower patient age. Due to the existence of well established primary haemophilia care in CCCs in Germany, the trend for the recent years is that the proportion of young patients that choose haemophilia care providers closer to their homes is increasing.

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