Surgical Treatment of Congenital Choanal Atresia

— In a follow-up, 2 to 27 years postoperatively, of 43 patients with unilateral choanal atresia a high frequency of relapses was observed. In 47% of the cases, preoperative symptoms had reappeared, and in 84% scar tissue had reduced the choanal opening to less than half of normal size. In most of the patients a transpalatinal approach was used, either ad modum Ruddy, Wilson or Owens. In order to improve the results, the surgical method and the postoperative treatment were changed in a new series of 15 patients with unilateral atresia. These patients, 6 to 26 years of age, were operated on by a transpalatinal approach during two months in the autumn of 1974. After removal of the atresia, the posterior part of the nasal cavity was modeled, with a dental drill, to increasing diameter towards epipharynx. To keep the opening patent a PVC tube was left in the choana for six weeks postoperatively. The results were encouraging. Two and a half years after the operation there were no relapses.

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Early Cosmetic Results and Midterm Follow-up Findings of Rhinophyma Patients Treated With High-Frequency Electrosurgery and a Discussion on the Severity Assessment of the Disease

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475417694860 ◽

2017 ◽

Vol 21 (3) ◽

pp. 221-226 ◽

Cited By ~ 2

Author(s):

Fatih Göktay ◽

Gamze Erfan ◽

Nil Su Çelik ◽

Canan Öztürk ◽

Tuba Doruk ◽

...

Keyword(s):

Surgical Treatment ◽

High Frequency ◽

Cost Effective ◽

Severity Index ◽

Assessment Methods ◽

Strong Positive Correlation ◽

Severity Assessment ◽

Severity Scores ◽

Severity Of The Disease

Background: Different methods can be used in the surgical treatment of patients with rhinophyma. There are limited numbers of reports on high-frequency electrosurgery treatment. In addition, an efficient scoring system is required to evaluate severity of the disease in clinical progress and recurrence after treatment. Objectives: We evaluated patients with rhinophyma who were treated with high-frequency electrosurgery and discussed the methods used to assess severity of the disease. Methods: Data and photos of 13 patients were retrospectively evaluated and scored via 2 different forms of the rhinophyma severity index. Results: Median rhinophyma severity index scores of patients at first visits were significantly higher than those at second and third visits ( P = .002 and P = .002, respectively). Likewise, median modified rhinophyma severity scores of patients at first visits were significantly higher than those at second and third visits ( P = .001 and P = .001, respectively). Also, there was a strong positive correlation between these 2 assessment methods ( r = 0.838, P < .001). Conclusions: The rhinophyma severity assessment methods used in this study are positively correlated. High-frequency electrosurgery seems to be a procedure that is safe, effective, and relatively cost-effective in the treatment of rhinophyma lesions.

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Congenital Posterior Choanal Atresia

PEDIATRICS ◽

10.1542/peds.76.3.429 ◽

1985 ◽

Vol 76 (3) ◽

pp. 429-436

Author(s):

Richard S. Stahl ◽

M. J. Jurkiewicz

Keyword(s):

Surgical Treatment ◽

Choanal Atresia ◽

Nasal Airway ◽

Neurologic Complications ◽

Facial Growth ◽

Recurrence Rates ◽

Major Morbidity ◽

Growth Disturbances ◽

Male Ratio

Although described more than two centuries ago, congenital choanal atresa remains an entity for which optimum treatment is not yet established. In a study of 29 cases of congenital choanal atresia during a 14-year period, 14 male and 15 female patients were diagnosed, in contrast with the 2:1 female-male ratio usually reported. Thirty-two operative procedures were performed on 16 surgically treated patients in the series. The two classes of surgical treatment, transpalatal and transnasal techniques, were marked by 66% and 73% recurrence rates, respectively, from 2 months to 6.5 years of follow-up. In previous studies, facial growth disturbances have been shown to result from transpalatal resection in the growing child, whereas transnasal techniques have been indicted as a cause of serious neurologic complications. Because no major morbidity resulted from 20 endonasal procedures in this series, early serial endonasal perforation is advocated as a means of establishing and maintaining a patent nasal airway until definitive transnasal repair can be performed when facial growth is more complete.

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Age-related description of the posterior structures of the nasal cavity in children

Journal of Anatomy and Histopathology ◽

10.18499/2225-7357-2020-9-3-9-15 ◽

2020 ◽

Vol 9 (3) ◽

pp. 9-15

Author(s):

I. V. Gaivoronskii ◽

M. V. Markeeva ◽

O. Yu. Aleshkina ◽

N. V. Tarasova

Keyword(s):

Nasal Cavity ◽

Anterior Part ◽

Treatment Options ◽

Choanal Atresia ◽

Posterior Part ◽

Surgical Access ◽

Age Related ◽

Morphometric Features ◽

Infancy And Early Childhood ◽

Pyriform Aperture

The aim of the study was to describe morphometric characteristics of the posterior parts of the nasal cavity in different periods of childhood and to specify the age-related norm for improving surgical treatment options of choanal atresia and providing an optimal access to the anterior part of the skull base. Material and methods. The study included 87 children aged 1-21 who were exposed to craniometry of the nasal cavity structures. Results. The age-related variability of the linear dimensions and shape of the choanae, their relationship with the dimensions of the pyriform aperture and the height of the nasal cavity in the posterior part were defined in the study. The increase in the height of the choanae and the height of the nasal cavity at the back starts from 2– 3 years of age, and the width – from 8–12 years of age. The height and width of the pyriform aperture are equal to the age of 8–12; these parameters increase in older children's groups with a predominance of the height over the width. The height of the nasal cavity at the back increases in all age periods. The growth of the studied structures of the nasal cavity is completed by adolescence. In infancy, the height of the choanae is less than the height of the nasal cavity at the back by 45%, and less than the height of the pyriform aperture by 20%; in adolescence, these ratios are 42% and 23%, respectively. In infancy the choanal width is less than the width of the pyriform aperture by 49%, and in adolescence – by 40%. In infancy and early childhood, the choanae are typically small in height and width. Their shape is round in 25% of cases, however, ovoid shape is also found. The height and width of the pyriform-shaped aperture at these age periods are similar and do not exceed 17–18 mm; the height of the nasal cavity at the back is 25–27 mm. Conclusion. The authors have described age-related morphometric features of the posterior structures of the nasal cavity. These features should be taken into account by otorhinolaryngologists and neurosurgeons when planning endoscopic intranasal surgical access in children. The younger the child is, the more difficult it is to perform a surgery due to the significant restriction of the access resulted from the small size of the piriform opening and the nasal cavity, and the obstinacy of the nasal septum. When performing choanotomy for atresia, it is necessary to form the choana comparing it in shape and size with the age-related norm

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Vaginal extirpation of the uterus using implants made of titanium silk to prevent recurrence of the disease

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.17816/2313-8726-2021-8-2-101-108 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Anatoliy I. Ishchenko ◽

Tat'yana V. Gavrilova ◽

Anton A. Ishchenko ◽

Oksana Y. Gorbenko ◽

Teya A. Dzhibladze ◽

...

Keyword(s):

Surgical Treatment ◽

Uterine Prolapse ◽

Titanium Implants ◽

New Method ◽

Vaginal Examination ◽

Titanium Mesh ◽

Surgical Method ◽

Pelvic Organs ◽

Reliable Tool

INTRODUCTION: The frequency of post-hysterectomy prolapse of the vaginal dome reaches 43% in patients after surgical treatment for complete uterine prolapse. Goal ― improving the effectiveness of surgical treatment with titanium mesh implants in pre- and postmenopausal patients with complete uterine prolapse. MATERIALS AND METHODS: The study involved 21 patients with complete uterine prolapse who underwent the proposed new method of transvaginal surgical prevention of post-hysterectomy prolapse of the vaginal dome. The result of surgical treatment was evaluated by analyzing the data of vaginal examination and ultrasound. RESULTS: Patients were observed for 2 years ― after 1, 6, 12 and 24 months. Analysis of vaginal examination and ultrasound data showed no displacement of the vaginal dome, pelvic organs and deformation of titanium implants. There were no mesh-associated complications during follow-up. CONCLUSIONS: The use of the developed surgical method for the correction of post-hysterectomy prolapse of the vaginal dome with the use of implants made of titanium silk is a reliable tool that provides anatomical efficiency in pre- and postmenopausal patients.

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Surgical treatment of choanal atresia in CHARGE association: case report with long-term follow-up

Journal of Cranio-Maxillofacial Surgery ◽

10.1054/jcms.1999.0068 ◽

1999 ◽

Vol 27 (5) ◽

pp. 321-326 ◽

Cited By ~ 2

Author(s):

F. Carinci ◽

A. Hassanipour ◽

S. Mandrioli ◽

A. Pastore

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Choanal Atresia ◽

Charge Association ◽

Long Term Follow Up

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Choanal atresia and secondary nasopharyngeal stenosis in a dog

Journal of the American Animal Hospital Association ◽

10.5326/15473317-34-6-497 ◽

1998 ◽

Vol 34 (6) ◽

pp. 497-501 ◽

Cited By ~ 32

Author(s):

BR Coolman ◽

SM Marretta ◽

BC McKiernan ◽

JF Zachary

Keyword(s):

Nasal Cavity ◽

Surgical Intervention ◽

Choanal Atresia ◽

Upper Airway ◽

Airway Disease ◽

Scar Tissue ◽

Endoscopic Examination ◽

Intact Male ◽

Temporary Relief

A 20-month-old, intact male shih tzu was evaluated for chronic upper airway disease. Endoscopic examination established a diagnosis of choanal atresia, a developmental anomaly of the posterior nasal cavity. Although surgical intervention provided temporary relief, stenosis of the nasopharynx by obstructive scar tissue was confirmed within four weeks. A permanent tracheostomy provided long-term relief of the respiratory difficulty. This is the first report of choanal atresia or nasopharyngeal stenosis in a dog.

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Operative treatment of pressure ulcers using pedicled flaps

Progress in Health Sciences ◽

10.5604/01.3001.0012.8329 ◽

2018 ◽

Vol 8 (2) ◽

pp. 105-111

Author(s):

M. Bielecki ◽

P. Bielecki ◽

P. Żebrowski ◽

B. Misiak ◽

J Lewko

Keyword(s):

Surgical Treatment ◽

Skin Necrosis ◽

Pressure Ulcers ◽

Bone Infection ◽

Postoperative Treatment ◽

Preoperative Preparation ◽

Careful Planning ◽

Pedicled Flaps ◽

Lower Back

Purpose: To present the results of surgical treatment concerning pressure ulcers. Materials and methods: All patients underwent surgical treatment at the Orthopedics and Traumatology Clinic from 1997 to 2016. One operator performed the procedures. A total of 28 pressure ulcers were operated (25 patients). The clinical material consisted of 15 pressure ulcers located in the lower back area, six pressure ulcers located in the ischial area, three pressure ulcers located in the trochanteric area and four pressure ulcers located in the heel area. Results: One conducted the result evaluation based on the criteria of complications proposed by Seiler. In case of all surgically treated patients, pressure ulcers appeared after 2-5 weeks after the surgery. One patient experienced hematoma below the slide piece. One could observe seroma in case of 5 patients. In this situation, it was required to apply a local postoperative puncture. Four patients experienced marginal skin necrosis (2 of them required resection of dead skin edges in operating block conditions which were later re-stitched using “side to side” technique). During the 3-year follow-up, there was no recurrence of operated pressure ulcers. Conclusions: Deep septic pressure ulcers, according to the division introduced by Seiler, connected with bone infection require the application of muscular-skin pieces. This procedure is aimed at improving local tissue blood supply. Proper preoperative preparation of the patient, careful planning of the surgery and suitable postoperative treatment of the patient are as significant as the surgery itself.

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CONSEQUENCES OF BURN INJURY OF ADNEXA IN CHILDREN. THE EFFECTIVENESS OF SURGICAL TREATMENT

Russian Pediatric Ophthalmology ◽

10.18821/1993-1859-2018-13-1-42-45 ◽

2018 ◽

Vol 13 (1) ◽

pp. 42-45

Author(s):

I. A Filatova

Keyword(s):

Surgical Treatment ◽

Contact Lenses ◽

Burn Injury ◽

Skin Grafting ◽

Scar Tissue ◽

Clinical Group ◽

Lead Glass ◽

Tissue Formation ◽

Scar Tissue Formation

Аim. Тo assess the effectiveness of surgical treatment of consequences of burn injury of adnexa in children. Material and methods. The analysis of clinical material over the past 10 years. The clinical group consisted of 59 patients (44 - male, 15 - female) with the consequences of burn injury of adnexa in age from 2 months to 18 years (m = 9.17 ±3.23 years). The burn trauma were the following: thermal (flame, hot objects, gas explosion) - 43, chemical (acid, alkali) - 11, combined (melted lead/glass) - 5. The time that has passed after the burn until the first stage of surgical treatment ranged from 1 month to 2 years (m= 9.7 ± 5.1 months). The author describes in detail the clinical picture, noting that significant lagophthalmos is dominated by the consequences of thermal burns, the consequences of chemical burns occurred entropion, symblepharon, leucoma. 11 patients had anophthalmos. In all, 121 operations were performed in 59 patients (1 to 4 stages, m = 2,1±1,1) with an interval from 3 to 12 months (m=8.3 months): removal of lagophthalmos with method of local plastics or free skin grafting; elimination of symblepharon or reconstruction of the conjunctival cavity with lips/cheeks’ mucous grafting; the strengthening of the eyelids’ edges, eyelashes plastic. The technics of the operation is described. Follow up period for patients from 6 months to 13 years (m=6,7±2,1). Results. Wound healing in all cases took place in the usual time. Skin sutures were removed after 7-9 days, traction sutures in 3 weeks, blepharorophy in 1-6 months. Engraftment of the transplanted free skin and mucous’ grafts was without a significant reduction. Visual function were preserved and improved in all the cases (44 patients). Cosmetic contact lenses were chosen in 4 patients with Vis = 0. A stable position of the prosthesis achieved in patients with anophthalmos. Conclusion. Consequences of burn injury of adnexa in children are diverse and require a differentiated approach to the choice of timing, priority, and methods of surgical treatment. Eyelid plasty is advisable to perform in the “cold” period after the completion of processes of scar tissue formation in the absence of threats to the condition of the eye.. Reconstruction should be performed at any time to prevent the development of ulcers or perforation of the cornea in the presence of the inversion of eyelids, symblepharon, significant lagophthalmos causing suffering of cornea.

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