Short-term Subjective and Objective Outcomes of Patients Receiving Endoscopic Transcanal Myringoplasty for Repairing Tympanic Perforations

2017 ◽  
Vol 158 (2) ◽  
pp. 337-342 ◽  
Author(s):  
Chih-Chieh Tseng ◽  
Ming-Tang Lai ◽  
Chia-Che Wu ◽  
Sheng-Po Yuan ◽  
Yi-Fang Ding
Keyword(s):  
Tertiary Care ◽  
Routine Activities ◽  
University Hospital ◽  
Secondary Outcome ◽  
Success Rates ◽  
Short Term ◽  
Hearing Results ◽  
The Mean ◽  
Graft Success ◽  
Objective Outcomes

Objective Endoscopic transcanal myringoplasty (ETM) has been an emerging technique for repairing tympanic perforations since the late 1990s. Objective outcomes (ie, graft success rates and hearing results) of patients who received ETM are well documented; however, subjective outcomes of these patients have rarely been reported. Hence, this study evaluated subjective and objective outcomes of patients who received ETM for repairing tympanic perforations. Study Design Prospective study. Setting Tertiary care university hospital. Patients and Methods Patients who underwent ETM for perforations of the tympanic membrane were included. We evaluated subjective variables of patients receiving ETM as the primary outcome and objective variables as the secondary outcome. Results In total, 91 ears that underwent ETM were included. The mean pain scale score was 0.1 (range, 0-2) on postoperative day 3. The mean duration of pain medication was 2.0 (range, 0-3) days. The mean number of days required to resume routine activities was 1.0 (range, 1-2) days. The overall graft success was determined postoperatively at 3 months in 80 of 91 ears (87.9%). Closure of the air-bone gap to within 20 dB was achieved in 79 (86.8%) ears. Conclusion In this study, patients who received ETM had mild postoperative pain and resumed routine activities early. These patients also exhibited favorable graft success rates and hearing results at 3 months postoperatively. On the basis of our results, we conclude that patients who receive ETM for the repair of tympanic perforations have favorable short-term subjective and objective outcomes.

Follow-Up Care Barriers for Patients with Orofacial Clefts

2021 ◽  
pp. 105566562110421
Author(s):  
Joshua Van Swol ◽  
Bethany J. Wolf ◽  
Julia Toumey ◽  
Phayvanh Pecha ◽  
Krishna G. Patel
Keyword(s):  
Outcome Measure ◽  
Tertiary Care ◽  
University Hospital ◽  
Exclusion Criteria ◽  
Actual Patient ◽  
The Mean ◽  
Return Visits ◽  
Significant Factors ◽  
Patient Attendance

Objective The aim of this study was to evaluate whether a patient with a cleft's age, associated syndrome, cleft phenotype or travel distance affects their follow-up rate. Design This study is a retrospective review of patients with CL/P treated by a craniofacial clinic. Setting The setting was a craniofacial clinic at a tertiary care university hospital. Patients, Participants Candidates were patients seen by the craniofacial clinic between January 2007 and December 2019. An initial pool of 589 patients was then reduced to 440 due to exclusion criteria. Interventions None Main Outcome Measure(s) The outcome measure was actual patient attendance to the craniofacial team compared to the team goal expectation of annual return visits. Results The mean age of participants at the end of the study was 9.0 ±  5.4 years with a mean follow-up period (total possible follow-up period length based on patient age at presentation and study window) of 5.5 ±  3.6 years. There was no association between cleft phenotype, type of syndrome, or distance to the clinic with attendance. Children with syndromes had an 11% decrease in the odds of attending follow-up visits with each 1-year increase in age compared to a 4% decrease in children without syndromes. Conclusions The only significant factors determining patient attendance were the presence of a syndrome and increasing age.

Over-under cartilage tympanoplasty: technique, results and a call for improved reporting

2020 ◽  
Vol 134 (10) ◽  
pp. 875-881
Author(s):  
I D Erbele ◽  
M R Fink ◽  
G Mankekar ◽  
L S Son ◽  
R Mehta ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Senior Author ◽  
Retrospective Case ◽  
Closure Rate ◽  
Hearing Results ◽  
Middle Ear Cholesteatoma ◽  
Cartilage Tympanoplasty ◽  
The Mean ◽  
Clinically Significant

AbstractObjectiveThis study aimed to describe the microscopic over-under cartilage tympanoplasty technique, provide hearing results and detail clinically significant complications.MethodThis was a retrospective case series chart review study of over-under cartilage tympanoplasty procedures performed by the senior author between January 2015 and January 2019 at three tertiary care centres. Cases were excluded for previous or intra-operative cholesteatoma, if a mastoidectomy was performed during the procedure or if ossiculoplasty was performed. Hearing results and complications were obtained.ResultsSixty-eight tympanoplasty procedures met the inclusion criteria. The median age was 13 years (range, 3–71 years). The mean improvement in pure tone average was 6 dB (95 per cent confidence interval 4–9 dB; p < 0.0001). The overall perforation closure rate was 97 per cent (n = 66). Revision surgery was recommended for a total of 6 cases (9 per cent) including 2 post-operative perforations, 1 case of middle-ear cholesteatoma and 3 cases of external auditory canal scarring.ConclusionOver-under cartilage tympanoplasty is effective at improving clinically meaningful hearing with a low rate of post-operative complications.

scholarly journals Factors Influencing Post-Operative Short-Term Outcomes of Vesicovaginal Fistula Repairs in a Community Hospital in Liberia

2011 ◽  
Vol 4 (6) ◽  
pp. 259-265 ◽  
Author(s):  
Oxana Munoz ◽  
C. Bryce Bowling ◽  
Kimberly A. Gerten ◽  
Rebecca Taryor ◽  
Andy M. Norman ◽  
...  
Keyword(s):  
Vesicovaginal Fistula ◽  
Primary Outcome ◽  
Community Dwelling ◽  
Success Rates ◽  
Short Term ◽  
Factors Influencing ◽  
Continence Status ◽  
The Mean ◽  
Continence Rate ◽  
First Time

Objectives: To assess factors influencing short-term outcomes of vesicovaginal fistula (VVF) repairs in community-dwelling women of Liberia, Africa. Methods: Forty patients who underwent VVF repairs were analyzed. Primary outcome was continence status at 14 days post repair. Factors influencing continence status were characterized. Results: The mean duration of leakage was 9.6 ±8.3 years, (3 months–28 years). Thirteen (33%) had previous repairs, and 6 (15%) had multiple fistula sites. Twenty-eight (70%) were continent at catheter removal. First time repairs had a higher continence rate compared to women with previous repairs, 78% and 54% respectively ( p = 0.15). Seven (47%) juxtaurethral repairs were considered failures, while only one (9%) juxtacervical fistula remained incontinent ( p =0.069). Controlling for duration of leakage, women with previous repairs were significantly less likely to be continent ( p = 0.04; adjusted OR = 0.07; 95% CI: 0.005, 0.83). Conclusions: Patients with previous VVF repairs and juxtaurethral fistulae experience lower success rates; surgery remains an effective treatment for many VVF patients.

scholarly journals Ultrasound-guided percutaneous renal biopsy at a university hospital: retrospective analysis of success and complication rates

2021 ◽  
Vol 54 (5) ◽  
pp. 311-317
Author(s):  
Orlando Vieira Gomes ◽  
Bianca Alencar Dias de Almeida ◽  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Guilherme Bruno Pires Marques Locio ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Complication Rates ◽  
Care Hospital ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Second Procedure

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.

Comparison of endoscopic butterfly-inlay versus endoscopic push-through myringoplasty in repairing anterior perforations of the tympanic membrane

2020 ◽  
Vol 134 (2) ◽  
pp. 128-134 ◽  
Author(s):  
S Gülşen ◽  
B Erden
Keyword(s):  
Tympanic Membrane ◽  
Operative Time ◽  
Operating Time ◽  
Functional Results ◽  
Success Rates ◽  
Open Label ◽  
Hearing Results ◽  
Reasonable Approach ◽  
Average Operative Time ◽  
Graft Success

AbstractObjectiveThe aim of the present study was to evaluate the surgical and functional results of endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty in the treatment of anterior perforation of the tympanic membrane.MethodThis open-label randomised clinical study was conducted on 71 patients with small- and medium-sized anterior perforations of the tympanic membrane. Graft success rate, hearing results, operative time and complications were analysed.ResultsGraft success rates for endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty were 94.1 and 91.8 per cent, respectively (p > 0.05). Post-operative air–bone gap values significantly improved in both the endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty groups. The average operative time was significantly shorter in the endoscopic butterfly-inlay cartilage myringoplasty group (31.5 minutes) compared to the endoscopic push-through myringoplasty group (41.7 minutes; p < 0.05).ConclusionWhen compared with the endoscopic push-through myringoplasty, the endoscopic butterfly-inlay cartilage myringoplasty technique, which is technically easier to perform, does not require packing and has a shorter operating time. It is a reasonable approach for repair of anterior perforations of the tympanic membrane.

Sacral anatomical interspace landmark for lumbar puncture in pregnancy

Neurology ◽  
2019 ◽  
Vol 94 (6) ◽  
pp. e626-e634
Author(s):  
Carlo Pancaro ◽  
Baskar Rajala ◽  
Christie Vahabzadeh ◽  
Ruth Cassidy ◽  
Thomas T. Klumpner ◽  
...  
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Lumbar Vertebra ◽  
University Hospital ◽  
Secondary Outcome ◽  
Mechanical Trauma ◽  
Office Visits ◽  
Convenience Sample ◽  
The Third ◽  
In Pregnancy

ObjectiveTo determine whether the sacral anatomical interspace landmark (SAIL) technique is more accurate than the classic intercristal line (ICL) technique in pregnant patients and to assess the percentage of clinical determinations above the third lumbar vertebra.MethodsIn this prospective, randomized, open-label trial, there were 110 singleton pregnant patients with gestational age greater than 37 weeks included. Selection procedure was a convenience sample of pregnant patients who presented for office visits or vaginal or cesarean delivery between March 15 and July 31, 2018, at a single-center obstetric tertiary care university hospital. Both techniques were evaluated by 2 physicians independently assessing each method. Before data collection, we hypothesized that the SAIL technique would be more accurate than the ICL technique in determining the L4-L5 interspace, and that the SAIL technique would produce more estimations below the third lumbar vertebra than the ICL technique. Therefore, the primary outcome was accuracy in identifying the L4-L5 lumbar interspace with SAIL vs ICL. The secondary outcome was difference in clinical assessments above the third lumbar vertebra. Both outcomes were measured via ultrasonography.ResultsPatients were 31 ± 5 years of age (mean ± SD) and had body mass index of 31.8 ± 5.7 kg/m2 and gestational age of 38.8 ± 1.1 weeks. A total of 110 patients were analyzed. SAIL correctly identified the L4-L5 interspace 49% of the time vs 8% using ICL (p < 0.0001). Estimations above L3 were 1% for SAIL vs 31% for ICL (p < 0.0001).ConclusionsOur study shows improved accuracy in identifying intervertebral space using the SAIL technique; this may prevent direct mechanical trauma to the conus medullaris when lumbar punctures are performed in pregnancy.Clinicaltrials.gov identifierNCT03433612.

scholarly journals Adrenal vein sampling using rapid cortisol assays in primary aldosteronism is useful in centers with low success rates

2011 ◽  
Vol 165 (2) ◽  
pp. 301-306 ◽  
Author(s):  
Matthias J Betz ◽  
Christoph Degenhart ◽  
Evelyn Fischer ◽  
Anna Pallauf ◽  
Volker Brand ◽  
...  
Keyword(s):  
Success Rate ◽  
Primary Aldosteronism ◽  
Femoral Vein ◽  
Tertiary Care ◽  
Control Period ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Adrenal Vein ◽  
Success Rates ◽  
Adrenal Vein Sampling

ObjectiveAdrenal vein sampling (AVS) is considered the gold standard in the differential diagnosis of primary aldosteronism (PA), but success rates vary between centers. We hypothesized that rapid (intraprocedure) cortisol measurement can improve performance in a center with initially low AVS success rate.DesignWe analyzed 46 patients with confirmed PA studied between 2008 and 2010. Forty-seven PA patients studied between 2004 and 2008 identified by retrospective chart review served as controls. All patients were treated at a single tertiary care university hospital.MethodsStarting in 2008, rapid cortisol assays (RCA) were performed in all patients during the AVS procedure. A cortisol gradient of ≥2.0 between adrenal vein and a femoral vein sample was used as success criterion. Up to two repeat samples were drawn if adrenal vein cortisol was below this threshold.ResultsDuring the control period 26 of 47 AVS were successful (55%). After introduction of RCA, 39 out of 46 AVS (85%) were successful (P=0.003). In 21 of the 46 cases (46%) a resampling was necessary. The increase in overall success was due to an increase in successful right AVS (85 vs 62% before introduction of RCA; P=0.02) and a training effect (P=0.024 for trend).ConclusionRCA during AVS are useful in centers with an initially low AVS success rate.

scholarly journals The Effectiveness of Thai Massage and Joint Mobilization

2017 ◽  
Vol 10 (2) ◽  
pp. 3
Author(s):  
Chantip Juntakarn, MA ◽  
Thavat Prasartritha, MD ◽  
Prapoj Petrakard, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Randomized Study ◽  
Secondary Outcome ◽  
Control Group ◽  
Low Back ◽  
Short Term ◽  
Joint Mobilization ◽  
The Mean

Background: Non-specific low back pain (LBP) is a common health problem resulting from many risk factors and human behaviors. Some of thesemay interact synergistically and have been implicated in the cause of low back pain. Massage both traditional Thai massage and joint mobilization as a common practice has been shown to be effective for some subgroup of nonspecific LBP patients.Purpose and Setting: The trial compared the effectiveness between traditional Thai massage and joint mobilization for treating nonspecificLBP. Some associated factors were included. The study was conducted at the orthopedic outpatient department, Lerdsin General Hospital, Bangkok, Thailand.Methods: Prospective, randomized study was developed without control group. The required sample size was estimated based on previouscomparative studies for effectiveness between techniques. Two primary outcome measures were a 0 to 10 visual analog scale (VAS) of pain andOswestry Disability Index (ODI). Secondary outcome measures were satisfaction of patients and adverse effects of the treatment. The ‘‘intention to treat’’ (ITT) and per protocol approach were used to compare the significance of the difference between treatment groups.Participants: One hundred and twenty hospital outpatients, 20 (16.7%) male and 100 (83.3%) female, were randomized into traditional Thai massage and joint mobilization therapy. The average age of traditional Thai massage and joint mobilization was 50.7 years and 48.3 years, respectively. Both groups received each treatment for approximately 30 minutes twice per week over a four-week period. Total course did not exceed eight sessions.Result: With ITT, the mean VAS of traditional Thai massage group before treatment was 5.3 (SD = 1.7) and ODI was 24.9 (SD = 14.7), while in jointmobilization groups, the mean VAS was 5.0 (SD = 1.6) and ODI was 24.6 (SD = 15). After treatment, the mean VAS and ODI were significantlyreduced (VAS = 0.51 (SD = 0.89) and ODI = 8.1 (SD = 10.7) for traditional Thai massage, VAS = 0.86 (SD = 1.49) and ODI = 8.26 (SD = 12.97) for joint mobilization). Constipation was found in 34 patients (28.3%).Conclusion: The traditional Thai massage and joint mobilization used in this study were equally effective for short-term reduction of pain and disability in patients with chronic nonspecific LBP. Both techniques were safe with short term effect in a chosen group of patients.

scholarly journals Investigation of the Role of the Cytomegalovirus as a Respiratory Pathogen in HIV-Infected Patients

1996 ◽  
Vol 3 (4) ◽  
pp. 235-240 ◽  
Author(s):  
Rafael E de la Hoz ◽  
Shizu Hayashi ◽  
Darrel Cook ◽  
Christopher Sherlock ◽  
James C Hogg
Keyword(s):  
Relative Risk ◽  
Hiv Infection ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Pneumocystis Carinii ◽  
Clinical Severity ◽  
University Hospital ◽  
Respiratory Pathogen ◽  
Short Term ◽  
Short Term Mortality

OBJECTIVE:To investigate the occurrence of cytomegalovirus (CMV) pneumonitis in the setting of human immunodeficiency virus (HIV) infection and whether the presence of CMV as copathogen is associated with increased clinical severity or short term mortality in patients withPneumocystis cariniipneumonia.DESIGN:Retrospective cohort study.SETTING:Tertiary care university hospital.PATIENTS:One-hundred and fourteen HIV-infected homosexual men with pneumonia, followed for a minimum of four weeks.MEASUREMENTS:Clinical indicators of severity of pneumonia, microbiology of bronchoalveolar fluid and relative risk of short term mortality.RESULTS:Only two cases of CMV pneumonitis were found, one together withP carinii. However, 45 of the 86 patients withP cariniipneumonia were co-infected with CMV. No difference in clinical severity was detected between patients co-infected withP cariniiand CMV and those withP cariniialone. The relative risk of short term mortality was 3.64 (95% CI 0.82 to 16.18), in patients with co-infection compared with those withP cariniialone. The risk reached statistical significance for patients with earlier stages of HIV infection.CONCLUSIONS:CMV pneumonitis occurs rarely in HIV-infected patients, while CMV co-infection occurs in at least 50% of the cases ofP cariniipneumonia. Although no difference in clinical severity was detected, this study suggests that short term mortality fromP cariniipneumonia may be increased by CMV co-infection, particularly in patients with earlier stages of the disease.

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