Management of Congenital Ear Malformations

1983 ◽  
Vol 92 (5) ◽  
pp. 504-509 ◽  
Author(s):  
Michael E. Glasscock ◽  
Alan J. Nissen ◽  
Mitchell K. Schwaber ◽  
C. Gary Jackson
Keyword(s):  
Surgical Technique ◽  
Historical Development ◽  
Surgical Techniques ◽  
Classification Systems ◽  
Significant Problem ◽  
Postoperative Results ◽  
Hearing Results ◽  
Canal Stenosis ◽  
Ear Malformations

In spite of modern diagnostic and surgical techniques, the results of congenital ear malformation surgery are often disappointing. Not only are hearing results less than expected, but also postoperative canal stenosis is a significant problem. This paper reviews the historical development of atresia surgery, the various classification systems, and the management of congenital ear malformations at The Otology Group. The authors' surgical technique is described and the postoperative results of 33 ear operations are discussed. Twenty-two of 33 cases showed some improvement in hearing. Postoperative stenosis occurred in 42% of atresia cases.

scholarly journals Pitfalls in Rhinoplasty: Avoiding Mismatch Between Anatomy, Patient Expectation and Mastery of The Surgeon

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Imam Susanto
Keyword(s):  
Surgical Technique ◽  
Confidence Level ◽  
Private Practice ◽  
Surgical Techniques ◽  
Aesthetic Surgery ◽  
Normal Person ◽  
Postoperative Results ◽  
Augmentation Rhinoplasty ◽  
New Techniques ◽  
And Performance

Background: Aesthetic surgery is a component of Plastic Surgery which deals with a “normal” person with neither disease nor disfigurement. They seek surgery to enhance appearance, which is expected to boost confidence level and performance. Because aesthetic patient come with no physical deformity, their expectation for perfection is high. As plastic surgeons, we must be aware of the pitfalls in our works, how much can we deliver the expectations of patients as suited to our knowledge and our capability in mastering surgical technique including the implementation of new techniques combined with technology. Our awareness throughout each surgery, and the obsession for perfection must measure up to what the patient desire. Patients and Method: A review of 3 augmentation rhinoplasty patient cases who come to my private practice between 2006-2012 with concern of postoperative results is presented, prior previous surgeries were done either by author or other surgeons. Result: All patients received surgical counseling and scheduled correctional surgeries, nearly all patient accepted the final results and were satisfied. Summary: Pitfalls are common in aesthetic surgeries. To prevent this, we must be aware all aspects involved starting from the first consultation with patient, carefully assess the anatomy and anomaly of each case, master the surgical techniques used, and careful when implementing new techniques. Finally, have the wisdom to say ‘no’ to patients who are not good candidates for aesthetic surgery. 

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children

2021 ◽  
pp. 019459982110151
Author(s):  
Rahul G. Baijal ◽  
Karla E. Wyatt ◽  
Teniola Shittu ◽  
Eugenia Y. Chen ◽  
Eric Z. Wei ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Chart Review ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Airway Disease ◽  
Respiratory Complications ◽  
Patient Factors ◽  
Children's Hospital ◽  
Reactive Airway Disease ◽  
Children’S Hospital

Objectives The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques. Study Design The study was a retrospective cohort study. Setting Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. Methods Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications. Results A total of 2437 patients underwent a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection. Conclusion Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.

Endoscopic Septal Spur Resection

1993 ◽  
Vol 7 (5) ◽  
pp. 213-216 ◽  
Author(s):  
Donald C. Lanza ◽  
Deborah Farb Rosin ◽  
David W. Kennedy
Keyword(s):  
Surgical Technique ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Valuable Alternative ◽  
Perioperative Morbidity ◽  
The Past ◽  
Septal Spur

A variety of surgical approaches exists for the management of nasal septal spurs in patients who undergo endoscopic sinus surgery (ESS). Treatment of septal spurs in the past has been frequently addressed by septoplasty which can result in increased bleeding and length of surgical procedure as well as mandate postoperative nasal packing. Individually each of these problems can jeopardize the success of endoscopic sinus surgery. An endoscopic approach, which targets the septal spur alone, can minimize perioperative morbidity. The purpose of this paper is to demonstrate the effectiveness of endoscopic septal spur resection (ESSR) for the management of significant septal spurs in 8 patients who underwent concurrent ESSR during ESS for chronic sinusitis. Surgical technique and postoperative results are discussed and suggest that ESSR is a valuable alternative to more traditional techniques.

Hydroxylapatite Ossicular Replacement Prostheses: A Four-Year Experience

1992 ◽  
Vol 106 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Robert A. Goldenberg
Keyword(s):  
Surgical Technique ◽  
Middle Ear ◽  
Control Group ◽  
Hearing Results ◽  
Extrusion Rate ◽  
Hearing Result ◽  
Ossicular Replacement ◽  
Middle Ear Implants

Between 1987 and 1991, I have used 215 hydroxylapatite middle ear implants, in various styles, for hearing reconstruction. The first such implants were composed entirely of hydroxylapatite. Because of intraoperative difficulties in shaping and trimming these prostheses, hybrid prostheses using Plasti-Pore were developed. For each of four implant designs (incus, incus-stapes, PORP, and TORP), the head is constructed from hydroxylapatite and the shaft from Plasti-Pore. Extrusion rate for the hybrid prostheses is low (4.3%). Hearing results from 47 patients with the hybrid hydroxylapatite prostheses, 140 patients with total hydroxylapatite prostheses, and 75 control group patients with homograft bone or Plasti-Pore prostheses were compared. A “successful” hearing result was achieved in 51.1%, 51.4%, and 60.0% of the three groups, respectively. Surgical technique for use of the new hybrid hydroxylapatite prostheses is described.

scholarly journals Hospitalization time after open appendectomy by three different surgical techniques

2014 ◽  
Vol 27 (3) ◽  
pp. 188-190 ◽  
Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Site Infection ◽  
Hospitalization Time ◽  
Contingency Coefficient ◽  
Appendicular Stump

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.

scholarly journals EVALUATION OF A TRAINING COURSE ON OPEN VASCULAR SURGICAL TECHNIQUES IN AORTOILIAC PATHOLOGY - 5 YEARS OF EXPERIENCE

2015 ◽  
Vol 88 (2) ◽  
pp. 196-202
Author(s):  
Bogdan Stancu ◽  
Florin Beteg ◽  
Aurel Mironiuc ◽  
Aurel Muste ◽  
Claudia Gherman
Keyword(s):  
Surgical Technique ◽  
Vascular Surgery ◽  
Prospective Study ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Technical Quality ◽  
Statistical Association ◽  
Abdominal Aortic

Introduction. The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008-2012), and to verify the viability and the feasibility of the vascular anastomoses.Material and method. Vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. Endpoints of the study were the surgical skills and the technical quality, evaluated on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants.Result. A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a semnificative statistical association between the quality of suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05).Conclusions. Our course contributed to the improvement of technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment as in human patients.

scholarly journals Simultaneous Penetrating Keratoplasty with Crescentic Inferior Keratoplasty in Advanced Pellucid Marginal Degeneration

2015 ◽  
Vol 4 (2) ◽  
pp. 60-62
Author(s):  
David Smadja ◽  
David Touboul ◽  
Valentine Saunier
Keyword(s):  
Visual Acuity ◽  
Surgical Technique ◽  
Penetrating Keratoplasty ◽  
Corneal Transplant ◽  
Long Term Outcomes ◽  
Postoperative Results ◽  
Junction Site ◽  
Biomechanical Parameters ◽  
Corneal Thinning

ABSTRACT Purpose To describe and report long-term outcomes of a surgical technique in advanced pellucid marginal degeneration (PMD) combining conventional central penetrating keratoplasty (PK) with an additional crescentic inferior keratoplasty, using a single corneal transplant. Results We report the case of a 55-year-old male patient, who underwent a customized sizing PK in his right eye for an advanced PMD, which combined a central PK with an additional crescentic inferior keratoplasty. The 1 year postoperative results show very good clinical outcomes, including visual acuity and biomechanical parameters, as well as tectonic outcomes, documented with high resolution optical coherence tomography (OCT) at the junction site between the two grafts. Conclusion Advanced PMD is a specifically challenging condition for keratoplasty due to an extreme peripheral corneal thinning. This surgical technique may facilitate inferior suturing and optimize the postoperative tectonic outcomes. How to cite this article Saunier V, Smadja D, Touboul D. Simultaneous Penetrating Keratoplasty with Crescentic Inferior Keratoplasty in Advanced Pellucid Marginal Degeneration. Int J Kerat Ect Cor Dis 2015;4(2):60-62.

scholarly journals Other Scar Types: Optimal Functional and Aesthetic Outcome of Scarring in Cleft Patients

2020 ◽  
pp. 51-57
Author(s):  
Wouter B. van der Sluis ◽  
Nirvana S. S. Kornmann ◽  
Robin A. Tan ◽  
Johan P. W. Don Griot
Keyword(s):  
Surgical Technique ◽  
Psychosocial Functioning ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Surgical Techniques ◽  
Anatomical Structures ◽  
Patient Dissatisfaction ◽  
Optimal Function ◽  
Scar Management

AbstractCleft lip and palate are facial and oral malformation due to failures in the embryologic craniofacial development during early pregnancy. A unilateral cleft lip and palate is the most common type, whereby the upper lip, the orbicularis muscle, the alveolar bone, the floor of the nose, and the hard and soft palate are interrupted, creating an open communication between nasopharynx and oropharynx. Patients with a cleft lip and palate are treated in specialized cleft centers by a multidisciplinary team. Having cleft lip and/or palate has a noteworthy impact on quality of life and psychosocial functioning. Postoperative scarring is a common cause of patient dissatisfaction. The goal of cleft lip surgery is to close the lip, provide optimal function in terms of speech, mastication, dental protection, breathing and feeding, and provide an aesthetically pleasing facial scar. Precise surgical technique and adequate aligning of anatomical structures is important for the postoperative aesthetic result and scar formation. Different surgical techniques are available for this purpose. Optimal scar management can be divided in surgical (precise surgical technique, planning, and adequate aligning of anatomical structures) and nonsurgical methods (botulinum toxin, silicone application, carbon dioxide fractional laser).

scholarly journals Surgical Correction of Penoscrotal Web: A Case Series With Literature Review

2020 ◽  
Author(s):  
Volkan Sarper Erikçi
Keyword(s):  
Surgical Treatment ◽  
Clinical Characteristics ◽  
Surgical Techniques ◽  
Case Series ◽  
Scrotal Skin ◽  
Penile Skin ◽  
Surgical Experience ◽  
Postoperative Results ◽  
Pediatric Urologist

INTRODUCTION: Penoscrotal webbing (PSW) is an anomaly of penis and it includes penile and scrotal skin aberration. There are various surgical techniques for repairing PSW with different terminologies. Herein we present our surgical experience of Z-plasty procedure in these cases. METHODS: In this retrospective study, 5 patients with an average age of 46 months who were diagnosed and under follow-up for PSW, between June 2017 and May 2019 were included. Along with demographic and clinical characteristics, treatment and follow-up records were collected. RESULTS: Isolated PSW was observed in 4 patients and one patient had an associated megameatus intact prepuce (MMIP) of a hypospadias variant in addition to PSW. Circumcision and ventral prepuce reconstruction of the penis with the aid of "Z-plasty" solved problem and acceptable postoperative results were obtained. DISCUSSION AND CONCLUSION: PSW is a condition that warrants surgical treatment. During the management of these children, in the case of suspicion of penile skin abnormality at the time of circumcision, it should be deferred and should be consulted to a pediatric surgeon or a pediatric urologist. Gentle surgical treatment is recommended for a favourable surgical and psychological result

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