Long-Term Follow-up of Tracheoesophageal Puncture Results

1996 ◽  
Vol 105 (7) ◽  
pp. 501-503 ◽  
Author(s):  
James A. Geraghty ◽  
Bonnie E. Smith ◽  
Barry L. Wenig ◽  
Louis G. Portugal
Keyword(s):  
Low Socioeconomic Status ◽  
Total Laryngectomy ◽  
Success Rates ◽  
Vocal Rehabilitation ◽  
Speech Rehabilitation ◽  
Long Term Follow Up ◽  
Tracheoesophageal Speech ◽  
Tracheoesophageal Puncture

Since its introduction by Blom and Singer in 1980, tracheoesophageal puncture with a voice prosthesis has become the most frequently recommended choice for speech rehabilitation of total laryngectomees. Many studies have reviewed the initial speech acquisition success rates following tracheoesophageal puncture; however, long-term follow-up in these initial successes has been lacking. In addition, factors predictive of long-term success with tracheoesophageal speech have not been defined. Over a 10-yearperiod, we retrospectively reviewed all total laryngectomy patients, including those who have undergone primary or secondary tracheoesophageal puncture, at the University of Illinois Hospital and Clinics and the Westside Veterans Administration Hospitals. Survival in the total laryngectomy cohort of 202 patients ranged from 35% to 50%. Forty of these patients underwent tracheoesophageal puncture, in whom survival was 75%. Short-term success with tracheoesophageal speech was approximately 70% for our patients, while long-term success was achieved in 66%. Despite low socioeconomic status and relatively high alcoholism rates, successful maintenance of tracheoesophageal speech was achieved in the majority of cases. Tracheoesophageal speech should therefore be considered as a primary method of vocal rehabilitation in all patients undergoing total laryngectomy.

Neoglottis Reconstruction Following Total Laryngectomy: The Emory Experience

1982 ◽  
Vol 90 (5) ◽  
pp. 569-575 ◽  
Author(s):  
Fred M.S. McConnel ◽  
John Teichgraeber
Keyword(s):  
Medical School ◽  
Revision Surgery ◽  
Total Laryngectomy ◽  
Perioperative Complications ◽  
Vocal Rehabilitation ◽  
Early Results ◽  
Emory University ◽  
Long Term Follow Up

A number of studies over the last decade have reported on a viability of the primary neoglottis reconstruction after total laryngectomy. Early results have been encouraging, although operative and perioperative complications are higher than with a classic laryngectomy. This article reports on a series of 13 neoglottis reconstructions performed at Emory University Medical School using the techniques developed by Mario Staffiert, MD. During the course of the study, the overall success rate has fallen from 80% at three years to 54% at five years. With each succeeding year there has been an increasing need for revision surgery. The series emphasizes the need for long-term follow-up in any vocal rehabilitation procedure.

scholarly journals Motion - Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments for the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 57-59
Author(s):  
Stanley M Branch
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Clinical Problem ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Ducts ◽  
Success Rates ◽  
Long Term Follow Up

Pain is the dominant clinical problem in patients with chronic pancreatitis. It can be due to pseudocysts, as well as strictures and stones in the pancreatic ducts. Most experts agree that obstruction could cause increased pressure within the main pancreatic duct or its branches, resulting in pain. Endoscopic therapy aims to alleviate pain by reducing the pressure within the ductal system and draining pseudocysts. Approaches vary according to the specific nature of the problem, and include transgastric, transduodenal and transpapillary stenting and drainage. Additional techniques for the removal of stones from the pancreatic duct include extracorporeal shockwave lithotripsy. Success rates for stone extraction and stenting of strictures are high in specialized centres that employ experienced endoscopists, but pain often recurs during long term follow-up. Complications include pancreatitis, bleeding, infection and perforation. In the case of pancreatic pseudocysts, percutaneous or even surgical drainage should be considered if septae or large amounts of debris are present within the lesion. This article describes the techniques, indications and results of endoscopic therapy of pancreatic lesions.

Modified neoglottis reconstruction following total laryngectomy: Long-term follow-up and results

1995 ◽  
Vol 105 (7) ◽  
pp. 714-716 ◽  
Author(s):  
James H. Brandenburg ◽  
Namrata Patil ◽  
Edie W. Swift
Keyword(s):  
Total Laryngectomy ◽  
Long Term Follow Up

scholarly journals Incidence and characteristics of left atrial appendage stumps after device-enabled epicardial closure

2019 ◽  
Vol 29 (5) ◽  
pp. 663-669 ◽  
Author(s):  
Etem Caliskan ◽  
Matthias Eberhard ◽  
Volkmar Falk ◽  
Hatem Alkadhi ◽  
Maximilian Y Emmert
Keyword(s):  
Computed Tomography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Success Rates ◽  
Imaging Data ◽  
Long Term Follow Up ◽  
Short And Long Term

Abstract OBJECTIVES High success rates for left atrial appendage (LAA) exclusion with the AtriClip (Atricure, USA) device have been reported in the literature. This study evaluated the presence and characteristics of residual LAA stumps after AtriClip LAA exclusion using postoperative short- and long-term computed tomography angiography (CTA). METHODS In this retrospective analysis, 43 of 291 consecutive patients undergoing cardiac surgery with concomitant LAA occlusion using the AtriClip device were identified with available postoperative short- and long-term follow-up by CTA. LAA patency and the absence or the size of a present residual LAA stump were assessed on 2-dimensional multiplanar reconstructions, on maximum intensity projection images and on volume-rendered 3-dimensional computed tomography reconstructions. Based on current recommendations, the threshold for a significant LAA stump length was defined <10 mm. RESULTS The LAA was successfully occluded in all 43 patients (100%) as confirmed by intraoperative transoesophageal echocardiography and CTA imaging with a mean follow-up duration of 7.1 ± 0.8 years post-implant. The absence of blood flow in the excluded LAA was confirmed in all cases. In 31 of 43 patients (72%), no residual stump (0 mm) was observed creating a smooth endocardial surface, CTA revealed residual LAA stumps in 11/43 patients (26%) with a length <10 mm and a significant residual stump with a depth of >10 mm (12 mm) in 1 patient (2%). The mean length, width and depth of the residual stumps were 5.8 ± 2.1, 4.4 ± 1.2 and 7.3 ± 2.3 mm, respectively. CONCLUSIONS This study investigated the incidence of residual stump formation (>10 mm) after LAA closure with the AtriClip device based on CTA imaging data obtained during short- and long-term follow-up. While no LAA stump was detectable in the majority of patients, a non-significant LAA stump (<10 mm) was present in 26% of cases, indicating a favourable LAA occlusion profile for the AtriClip device. However, although a LAA stump length <10 mm is currently considered clinically safe, this definition needs further attention in future studies with regards to its potential clinical implications.

Voice Rehabilitation After Total Laryngectomy and Postoperative Radiation Therapy

2002 ◽  
Vol 20 (10) ◽  
pp. 2500-2505 ◽  
Author(s):  
William M. Mendenhall ◽  
Christopher G. Morris ◽  
Scott P. Stringer ◽  
Robert J. Amdur ◽  
Russell W. Hinerman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Total Laryngectomy ◽  
Voice Rehabilitation ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Artificial Larynx ◽  
Postoperative Irradiation ◽  
Tracheoesophageal Puncture

PURPOSE: The purpose of this study was to evaluate voice rehabilitation after laryngectomy and postoperative irradiation for patients with squamous cell carcinoma of the larynx and hypopharynx. PATIENTS AND METHODS: Between December 1983 and December 1998, 173 patients underwent a total laryngectomy and postoperative irradiation and had follow-up from 3 to 188 months (median, 38 months). Three patients were lost to follow-up at 63, 39, and 4 months after treatment. All other living patients had follow-up for 2 years or longer. Twelve (7%) patients had incomplete data pertaining to voice rehabilitation. RESULTS: Data pertaining to voice rehabilitation were available at 2 to 3 years and longer and 5 years and longer after treatment for 118 and 69 patients, respectively. The methods of voice rehabilitation at 2 to 3 years and longer and 5 years and longer were as follows: tracheoesophageal, 27% and 19%; artificial larynx, 50% and 57%; esophageal, 1% and 3%; nonvocal, 17% and 14%; and no data, 5% and 7%, respectively. CONCLUSION: The most common form of voice rehabilitation after total laryngectomy and postoperative radiation therapy is the artificial larynx. Although the tracheoesophageal puncture is a technique frequently promoted by clinicians as a superior method, a relatively small subset of patients are successfully rehabilitated long-term. However, of those who undergo a tracheoesophageal puncture, approximately half will use this method of voice rehabilitation long term.

Trabectome, trabecular aspiration and phacoemulsification in a triple procedure for treating exfoliation glaucoma: A long-term follow-up

2020 ◽  
pp. 112067212095650
Author(s):  
Randolf Alexander Widder ◽  
Matthias Hild ◽  
Thomas Stefan Dietlein ◽  
Pia Kühnrich ◽  
Corinna Rennings ◽  
...  
Keyword(s):  
Success Rates ◽  
Exfoliation Glaucoma ◽  
Medication Score ◽  
Triple Procedure ◽  
Trabecular Aspiration ◽  
Long Term Follow Up ◽  
The Mean ◽  
Tube Versus

Purpose: This study investigates the long-term intraocular pressure (IOP) lowering potential, risk profile and success rate of a triple procedure comprising phacoemulsification, trabecular aspiration and trabectome (Microsurgical Technology, Redmond, WA, USA) for treating exfoliation glaucoma. Methods: A total of 117 eyes of 117 patients with exfoliation glaucoma underwent a combination of phacoemulsification, trabectome and trabecular aspiration. They were followed up for up to 7 years. The success rates were designated according to criteria based on the Tube versus Trabeculectomy Study and the World Glaucoma Association guidelines: A (no resurgery); B/C (IOP < 21/18 mmHg, no resurgery, IOP reduction > 20%); D (IOP ⩽ 15 mmHg, no resurgery, IOP reduction ⩾ 40%). Results: The mean follow-up period was 46 months. IOP showed a 38% reduction from 24.5 ± 6.1 to 15.2 ± 3.6 mmHg ( p < 0.0001). The Medication Score decreased by 23% from 2.2 ± 0.9 to 1.7 ±1.0 ( p < 0.0001). The success rates were 87, 76, 74 and 38% according to criteria A, B, C and D. In eyes with an initial IOP of >30 mmHg, a 57% reduction from 34.2 ± 4.4 to 14.8 ± 3.2 mmHg ( p < 0.0001) was observed, and the success rates were 91, 91, 82 and 59% for criteria A, B, C and D, respectively. Discussion: We conclude that the triple procedure may effectively lower IOP in patients with exfoliation glaucoma over a mean follow-up period of 46 months without significant side effects. Therefore, the triple procedure may serve as first-line surgery for patients with exfoliation and cataract, even with a high initial IOP.

Analysis of branch artery orifice angulation: Feasibility of the shelf technique for the treatment of wide-neck bifurcation aneurysms

2020 ◽  
pp. 159101992097625
Author(s):  
Mehmet Onay ◽  
Ali Burak Binboga ◽  
Cetin Murat Altay
Keyword(s):  
Excellent Agreement ◽  
Clinical Success ◽  
Success Rates ◽  
Angle Measurements ◽  
Long Term Follow Up ◽  
Double Stent ◽  
Α Angle ◽  
Wide Neck

Background and purpose The aim of this study was to investigate the feasibility of the shelf technique by analyzing the angle between the two branch orifices and to present its safety and effectiveness compared with that of the double-stent technique. Materials and methods Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent stent-assisted coiling (SAC) were reviewed. The study sample was divided into two groups: single SAC (shelf technique) and double SAC. The angle between the lines connecting the superior and inferior points of each branch orifice (α angle) was measured by two neurointerventional radiologists in both groups. The inter- and intraobserver repeatability and consistency of the α angle were assessed. The effect of the α angle on the feasibility of using the shelf technique to treat WNBA was analyzed. Technical and clinical success rates were investigated by comparing both groups. Results Forty-eight patients (32 shelf technique and 16 double-stent technique) were included. There was excellent agreement between the intra- and interobserver repeatability and consistency of α angle measurements. The α angle was smaller in the shelf technique group than in the double-SAC group (p < 0.001). The technical and clinical success rates of both groups were similar based on long-term follow-up (p > 0.05). Conclusion WNBA treatment with the shelf technique is safe and effective. The α angle is a useful parameter to evaluate the performance of the shelf technique. The shelf technique is more suitable for WNBAs with a narrow α angle.

scholarly journals Long-term Safety and Feasibility of Left Bundle Branch Pacing in A Large Single Center Study

2021 ◽  
Author(s):  
Lan Su ◽  
Songjie Wang ◽  
Shengjie Wu ◽  
Lei Xu ◽  
Zhouqing Huang ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Complication Rates ◽  
Success Rates ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Long Term Follow Up ◽  
Large Observational Study

Background - Left bundle branch pacing (LBBP) is a novel pacing method and has been observed to have low and stable pacing thresholds in prior small short-term studies. The objective of this study was to evaluate the feasibility and safety of LBBP in a large consecutive diverse group of patients with long-term follow up. Methods - This study prospectively enrolled 632 consecutive pacemaker patients with attempted LBBP from April 2017 to July 2019. Pacing parameters, complications, ECG, and echocardiographic measurements were assessed at implant, and during follow-up of 1, 6, 12 and 24 months. Results - LBBP was successful in 618/632 (97.8%) patients according to strict criteria for LBB capture. Mean follow-up time was 18.6±6.7 months. 231 patients had follow-up over 2 years. LBB capture threshold at implant was 0.65±0.27 [email protected] and 0.69±0.24 [email protected] at 2-year follow-up. A significant decrease in QRS duration was observed in patients with LBBB (167.22 ± 18.99ms vs. 124.02 ± 24.15ms, p<0.001). Post implantation left ventricular ejection fraction improved in patients with QRS≥120ms (48.82±17.78 % vs. 58.12±13.04 %, p<0.001). The number of patients with moderate and severe tricuspid regurgitation decreased at 1-year. Permanent right bundle branch injury occurred in 55 (8.9%) patients. LBB capture threshold increased to more than 3 V or loss of bundle capture in 6 patients (1%), 2 patients of them had loss of conduction system capture. Two patients required lead revision due to dislodgement. Conclusions - This large observational study suggests that LBBP is feasible with high success rates and low complication rates during long term follow up. Therefore, LBBP appears to be a reliable method for physiological pacing for patients with either a bradycardia or heart failure pacing indication.

scholarly journals LARYNGEAL SYNOVIAL SARCOMA – A CASE REPORT

2020 ◽  
Vol 7 (3) ◽  
pp. 110-113
Author(s):  
Alexandru Nicolae Vlăescu ◽  
Elena Ioniță ◽  
Andreea Nicoleta Vlăescu ◽  
Florin Anghelina ◽  
Iulică Ioniță ◽  
...  
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Synovial Sarcoma ◽  
Multidisciplinary Team ◽  
Total Laryngectomy ◽  
The Past ◽  
Long Term Follow Up ◽  
Emergency Tracheotomy

Laryngeal synovial sarcoma is an extremely rare mesenchymal tumor. During the past four decades, literature findings revealed under 40 cases with this localization. We are bringing forward the case of a 70-year-old male patient who was referred to the ENT Clinic as a respiratory emergency – a tumor obstructing the laryngeal glottis, for which an emergency tracheotomy was initially performed, followed by a CT scan and a biopsy under general anesthesia through suspension videolaringoscopy. The histopathological report was suggestive of a biphasic synovial sarcoma. A multidisciplinary team set the surgical indication for total laryngectomy followed by chemo-radiotherapy. Long-term follow-up is mandatory for recurrence prevention. Patient has checked in for follow-up every 3 months over the past 2 years, with no macroscopic signs of tumoral relapse.

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