Endoscopic Surgical Management for Laryngomalacia

1987 ◽  
Vol 96 (6) ◽  
pp. 650-653 ◽  
Author(s):  
Kevin T. Kavanagh ◽  
Richard W. Babin
Keyword(s):  
Airway Obstruction ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Surgical Intervention ◽  
Preoperative Evaluation ◽  
Supraglottic Airway ◽  
Direct Visualization ◽  
Glottic Opening ◽  
The Many ◽  
Severe Airway Obstruction

Laryngomalacia is the most common of the many causes of respiratory stridor in the newborn. It may be identified by fiberoptic nasopharyngoscopy in the nursery or office. Several anatomic mechanisms of supraglottic collapse have been reported in the literature. The most common is a narrowing of the supraglottic airway with blockage of the glottic opening by the redundant tissue of the aryepiglottic folds. Although surgery rarely is indicated, severe airway obstruction, necessitating surgical intervention, can occur. Resection of supraglottic tissue should be performed only as an alternative to tracheotomy. Surgical procedures ranging from tracheotomy to epiglottidectomy have been advocated. Direct visualization of the obstructing tissue by nasopharyngoscopy allows the planning of an appropriate surgical procedure. In a patient with lateral supraglottic collapse, deep resection of the epiglottis would be expected to weaken the support of the aryepiglottic folds and aggravate the airway condition. Similarly, resection of tissue along the aryepiglottic folds will be useful only if preoperative evaluation demonstrates the obstruction to be at this location.

scholarly journals Why Do Patients Bleed?

2016 ◽  
Vol 02 (01) ◽  
pp. e29-e43 ◽  
Author(s):  
Jennifer Curnow ◽  
Leonardo Pasalic ◽  
Emmanuel Favaloro
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Surgical Intervention ◽  
Drug Intake ◽  
Patient History ◽  
Current Review

Patients undergoing surgical procedures can bleed for a variety of reasons. Assuming that the surgical procedure has progressed well and that the surgeon can exclude surgical reasons for the unexpected bleeding, then the bleeding may be due to structural (anatomical) anomalies or disorders, recent drug intake, or disorders of hemostasis, which may be acquired or congenital. The current review aims to provide an overview of reasons that patients bleed in the perioperative setting, and it also provides guidance on how to screen for these conditions, through consideration of appropriate patient history and examination prior to surgical intervention, as well as guidance on investigating and managing the cause of unexpected bleeding.

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

scholarly journals Prognostic Nutritional Index Considering Resection Range Is Useful for Predicting Postoperative Morbidity of Hepatectomy

2021 ◽  
Author(s):  
Shigeyuki Nagata ◽  
Shohei Maeda ◽  
Satoko Nagamatsu ◽  
Seiichiro Kai ◽  
Yasuro Fukuyama ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Procedures ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Major Hepatectomy ◽  
Prognostic Nutritional Index ◽  
Complication Rates ◽  
Immunological Status ◽  
Grade Ii ◽  
Prognostic Nutrition Index

Abstract Background Poor preoperative nutritional and immunological status are major risk factors for postoperative complications in patients with various malignancies. Lower preoperative prognostic nutrition index (PNI) is associated with higher rates of postoperative complications and poorer prognosis in those patients. The aim of this study was to analyze the predictive value of the PNI for post-hepatectomy complications in patients with hepatocellular carcinoma (HCC), and evaluate its utility in the surgical procedure. Methods This retrospective study included 510 patients who underwent open hepatectomies for HCC. The predictive value of the preoperative nutritional and immunological status for postoperative complications was assessed using the PNI. Postoperative complications were defined as grade II or higher per the Clavien-Dindo classification. Postoperative complication rates were compared according to surgical procedure (major hepatectomy vs minor hepatectomy). Results Patients with postoperative complications had significantly lower PNIs than those without (43.1 ± 5.5 vs 47.0 ± 5.7, P < 0.001). In the multivariate analysis, low preoperative PNI (< 45) was an independent risk factor for postoperative complications after hepatectomy (hazard ratio, 3.85). When patients were classified per their PNI (high vs low) and extent of surgical procedures (major vs minor), there were more complications among patients with low PNI than those with high PNI, regardless of the extent of surgical procedures. Specifically, the group of patients with low PNI who underwent major hepatectomy had significantly higher rates of postoperative complications than the other groups. Conclusions Adding the resection range to the PNI is useful for predicting the postoperative morbidities of hepatectomy patients.

VOLUME MANIPULATION FOR SIMULATING FACIAL CONTOURING SURGERY

2014 ◽  
Vol 26 (01) ◽  
pp. 1450016 ◽  
Author(s):  
Ming-Dar Tsai ◽  
Feng-Chou Tsai ◽  
Chih-Lung Lin ◽  
Ming-Shium Hsieh
Keyword(s):  
Wound Healing ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Tissue Deformation ◽  
Bone Morphology ◽  
Facial Bone ◽  
High Quality ◽  
3D Images ◽  
Case Examples ◽  
The Face

In facial contouring surgery, surgeons operate the facial bone to correct bone morphology and thus achieve esthetic feminine face. To evaluate the face appearance after surgery and rehearse every surgical procedure in facial contouring surgery, simulations for tissue peeling, incising and suturing on the face together with bone burring and grafting on the facial bone are required. This paper presents a method that transforms respective tissue vertices to simulate tissue peeling. The transformation is based on specified incisions and clamps as in real facial contouring surgery. This paper also uses an auxiliary structure to represent and record tissue boundary changes inside the face. The elastic, partially plastic and plastic tissue deformation and wound formation during an incision can be simulated by manipulating these boundary changes. The incised wound recorded in the auxiliary structure is also manipulated to simulate tissue generation in wound healing during a suture. This volume manipulation method is combined with the reported method for bone burring and grafting simulations so that high-quality 3D images for illustrating surgical procedures both on the face and facial bone can be achieved. Simulations of two case examples including tissue peeling, incising and suturing procedures, and three modalities of facial contouring surgery demonstrate the effectiveness of the proposed method and system.

scholarly journals A Survey of Competency-Based Training of Senior House Officers in Performing Minor Surgical Procedures

2006 ◽  
Vol 88 (6) ◽  
pp. 576-578 ◽  
Author(s):  
Samuel CL Leong ◽  
Alison J Waghorn
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Minor Surgical Procedures ◽  
Surgical Trainees ◽  
Competency Based ◽  
A Minor ◽  
Second Procedure ◽  
And Training

INTRODUCTION The aim of this survey was to ascertain the level of competency and training of basic surgical trainees (SHOs) in performing incision and drainage of a perianal abscess (a minor surgical procedure). MATERIALS AND METHODS Questionnaires were sent to SHOs enquiring about preferred methods of incision and drainage and the teaching received to perform this procedure. RESULTS Of respondent SHOs, 10% did not receive teaching when performing their first incision and drainage and over half did not received any feedback from their trainers. A mere 65% received practical supervision. Use of the curette and de-roofing of the abscess are not routine methods used. In addition, 13% reported inadequate incision and drainage, which required a second procedure. CONCLUSIONS Competency-based training in minor surgical procedures benefits not only from didactic teaching, immediate supervision and appraisal but also from frequent practise. This was found to be lacking for incision and drainage of perianal abscesses by basic surgical trainees surveyed in the study.

scholarly journals MODERN TRENDS TO LAPAROSCOPIC SURGERY IN GYNECOLOGY

2010 ◽  
Vol 1 (3) ◽  
pp. 98-102
Author(s):  
S A Levakov ◽  
A G Kedrova ◽  
N S Wanke
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Procedures ◽  
Endoscopic Sinus Surgery ◽  
Surgical Procedure ◽  
Sinus Surgery ◽  
Surgical Tool ◽  
Gynecologic Laparoscopy

Gynecologic laparoscopy has evolved from a limited surgical procedure used only for diagnosis and tubal ligations to a major surgical tool used to treat a multitude of gynecologic indications. Today, laparoscopy is one of the most common surgical procedures performed by gynecologists. The review presents the main trends of development of modern surgery in gynecology with the author's personal views on the key contentious issues of endoscopic sinus surgery.

Physical Signs in Childhood Asthma

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 537-541
Author(s):  
J. O. O. Commey ◽  
Henry Levison
Keyword(s):  
Pulmonary Function ◽  
Airway Obstruction ◽  
Pulmonary Function Tests ◽  
Severe Disease ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Scalene Muscle ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Severe Airway Obstruction

In 62 children with bronchial asthma, the presence of subjective dyspnea and wheeze, and some physical signs commonly associated with chronic obstructive airway disease in older patients, were compared with results of routine pulmonary function tests. Overall, airway resistance and the relationships of residual volume and functional residual capacity to total lung capacity were increased and other measurements of pulmonary function were moderately decreased. The time-honored subjective dyspnea, wheeze, rhonchi, and prolonged expiration were least useful as indices of severity of disease. Most of the patients, particularly those in whom laboratory testing revealed marked impairment, had notable rhonchi, prolonged expiration, scalene muscle and sternocleidomastoid contraction, and supraclavicular indrawing. Only sternocleidomastoid contraction and supraclavicular indrawing clearly correlated with the severity of airway obstruction. A call is made for a search for these useful signs, whose presence may be the only clue to moderately severe disease; however, their absence does not guarantee absence of severe airway obstruction.

Surgery for short sight?

1991 ◽  
Vol 29 (17) ◽  
pp. 65-66
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Contact Lenses ◽  
Photorefractive Keratectomy ◽  
Radial Keratotomy ◽  
The Press ◽  
Potential Demand ◽  
The Subject

People with short sight may learn of surgical procedures which enable them to see clearly without spectacles or contact lenses, often from articles in the press. These may present a somewhat rosy view of the subject; complications can follow any surgical procedure and surgery for myopia is no exception. The potential demand for such surgery is huge; about 5% of people in Britain have myopia in the range from −2 to −8 dioptres. Two procedures are used to correct myopia in these patients: radial keratotomy and laser photorefractive keratectomy.

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