scholarly journals Unusual Location of a Fungus Ball: The Concha Bullosa, a Review of the Literature

2021 ◽  
Vol 12 ◽  
pp. 215265672110361
Author(s):  
Walid Bijou ◽  
Bushra Abdulhakeem ◽  
Karim Choukry ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Demographic Data ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Review Of The Literature ◽  
Gender Ratio ◽  
Fungal Ball ◽  
The Mean ◽  
Rare Diagnosis ◽  
Tomography Scan

Introduction The fungal balls of the paranasal sinuses are usually seen in the maxillary and sphenoid sinuses. Although, the lesion of the concha bullosa, without sinus participation, is very uncommon. We report the case of a fungal ball of concha bullosa in an 88-year-old patient. Objective The objective of our review of literature is to investigate the epidemiological, clinical, paraclinical, and therapeutic characteristics of patients diagnosed with fungus ball in concha bullosa. Methods A case of a patient who was diagnosed with concha bullosa of a fungus ball is reported. Demographic data, clinical presentation, imaging, and treatments were recorded. Key images were obtained. A review of the literature was also performed. Results A total of 12 cases have been reported so far in the literature revealed by different symptoms. The mean age was 38.8 years and the gender ratio was ∼12 (female):1 (male). The endoscopic surgical approach was the most frequently used treatment and provides good outcomes. Neither postoperative complications nor recurrences were noted, however, there is insufficient follow-up data. Conclusion Concha bullosa fungal ball is a rare diagnosis that can be revealed by different symptoms. It should be considered in patients with and unexplained chronic facial pain. A preoperative computed tomography scan is an essential tool in making a diagnosis. Endoscopic surgery is the treatment of choice, with a low morbidity and recurrence rate.

scholarly journals Anorectal Malignant Melanoma: Retrospective Analysis of Six Patients and Review of the Literature

2018 ◽  
Vol 119 (2-3) ◽  
pp. 97-106 ◽  
Author(s):  
Ibrahim Atak
Keyword(s):  
Malignant Melanoma ◽  
Retrospective Analysis ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Review Of The Literature ◽  
Oncological Treatment ◽  
Malignant Melanomas ◽  
Anorectal Malignant Melanoma ◽  
The Mean

Malignant melanomas are rare aggressive tumours originating from the pigment-producing melanocytes. In our study, a review of the literature and a retrospective analysis of patients undergoing surgery at our clinic due to anorectal malignant melanoma were performed. The information of 6 patients undergoing surgery in our clinic due to anorectal malignant melanoma between January 2010 and January 2018 was retrieved retrospectively. The patients were assessed regarding demographic data, physical examination and imaging findings, the surgical method performed, postoperative complication, histopathological findings, oncological treatment and follow-up results. Four of the patients were female and 2 were male and the mean age was 61.6 (46–83) years. Two patients (33%) had liver metastases at the time of initial presentation. Abdominoperineal resection (APR) was performed in all patients 3 with laparoscopic method. The mean length of hospital stay was recorded to be 6.5 ± 1 days (5–12 days). Adjuvant chemotherapy and radiotherapy were administered in all patients. Also, interferon treatment was administered in one patient additionally. During the follow-up, 4 patients died due to extensive metastatic disease determined approximately in the 13th month. Two patients with regular follow-up are well and free of disease and their mean postoperative lifetime has been determined to be 12.5 months (6–26 months). Anorectal malignant melanomas (ARMM) are rare but aggressive tumours. The treatment should be focused on minimizing morbidity and maximizing the quality of life and function while removing the gross tumour.

scholarly journals Is the sublay self-gripping mesh effective for incisional ventral hernia repair? Our experience and a systematic review of the literature

2020 ◽  
Vol 72 (4) ◽  
pp. 1195-1200
Author(s):  
Elena Schembari ◽  
Maria Sofia ◽  
Rosario Lombardo ◽  
Valentina Randazzo ◽  
Ornella Coco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Demographic Data ◽  
Review Of The Literature ◽  
Long Term Follow Up ◽  
The Mean ◽  
Retromuscular Repair ◽  
Sublay Mesh

AbstractSublay mesh repair seems to be the most effective method for treating incisional hernias (IHs). The aim of this study was to report our experience with retromuscular repair and self-gripping mesh for the treatment of midline IHs. In addition, we provided a systematic review of the literature regarding the use of this novel combination. All patients undergoing elective IH repair from June 2016 to November 2018 were included. The self-gripping mesh was placed in the sublay position. Demographic data, defect sizes, postoperative complications and follow-up durations were collected. A systematic review of the available literature was conducted in January 2020 using main databases. A total of 37 patients (20/17M/F) were included in this study, and the mean age and body mass index (BMI) were 58 years and 27 kg/m2, respectively. Minor complications occurred in six patients. Long-term follow-up demonstrated recurrence in three patients. Regarding the review, five publications were considered relevant. The highest complication rate was 28.6%, and the recurrence rate varied from 0 to 5.1%. This is the first review of the literature regarding sublay IH repair using a self-gripping mesh. The low rates of postoperative complications and recurrence in our experience and those reported by most of the reviewed articles demonstrate that this is a safe and effective method for repairing IHs.

scholarly journals Flow diverter stents in the treatment of recanalized intracranial aneurysms

2021 ◽  
pp. 159101992199050
Author(s):  
Erol Akgul ◽  
Hasan Bilen Onan ◽  
Irem Islek ◽  
Mehmet Tonge ◽  
Yavuz Durmus ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Demographic Data ◽  
Previous Treatment ◽  
Flow Diverter ◽  
Serious Adverse Events ◽  
Clinical Complications ◽  
Tertiary Hospitals ◽  
The Mean ◽  
Technical Complication

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

Trapeziectomy and Suture-Button Suspensionplasty for Basilar Thumb Arthritis: Is It Enough to Prevent First Ray Subsidence?

2020 ◽  
Author(s):  
Ana Moreira Ferrão ◽  
Bruno Morais ◽  
Nuno Marques ◽  
João Nóbrega ◽  
José Monteiro ◽  
...  
Keyword(s):  
Demographic Data ◽  
Early Mobilization ◽  
Functional Results ◽  
Medium Term ◽  
Suture Button ◽  
First Ray ◽  
The Mean ◽  
End Stage ◽  
Good Medium

Abstract Introduction Trapeziectomy and suture-button suspensionplasty (SBS) are a novel option to treat end-stage trapeziometacarpal (TMC) osteoarthritis. Our purpose is to evaluate our outcomes with this technique and in this setting, with a minimum of 18 months of follow-up. Materials and Methods Twenty-eight patients were included, operated between 2016 and 2018. We recorded demographic data, preoperative Eaton stage, follow-up and operative times. The patients completed the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and tip pinch, key pinch, and grip strength were measured. First metacarpal subsidence was calculated, and postoperative complications were documented. Results The average follow-up was 34 months. The mean QuickDASH was 32 at the final follow-up. The average strength results were 20 kg for grip, 3.6 kg for tip pinch, and 4.2 kg for key pinch. The rate of first ray subsidence was 10.7%. We encountered three complications: a hardware intolerance, a second metacarpal fracture, and a suture rupture. There was one reoperation to remove an implant. Conclusion Trapeziectomy and SBS functional results are similar to other techniques, with less subsidence of the first ray and allowing for early mobilization and fast recovery. This procedure is a safe and promising option in the treatment of TMC osteoarthritis, with good medium-term outcomes.

Evaluation of Sports-Related Concussion in Children (5–12) and Adolescents (13–18)

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S12.3-S13
Author(s):  
James Pate ◽  
Ian Cummins ◽  
Kasey Cooper ◽  
James Mooney ◽  
Marshall Chandler McLeod ◽  
...  
Keyword(s):  
Demographic Data ◽  
Skull Fracture ◽  
Age Groups ◽  
Child And Adolescent ◽  
Return To Play ◽  
Specific Outcome ◽  
The Mean ◽  
New Diagnosis ◽  
Mean Time

ObjectiveThe objective of this study was to examine the association between sport/non-sport concussions as well as age and time to recovery after concussion diagnosis in children and adolescents.BackgroundThere is an ongoing debate between policy makers and medical specialists on when is the appropriate time to allow children to begin playing contact sports. This dilemma is important because sports are incredibly prevalent in our child and adolescent population today. There is still significant debate if age at time of concussion diagnosis is associated with long term affects and time to recovery.Design/MethodsOf the 725 patients who received a diagnosis of concussion at Children's of Alabama (COA) from 2018 to 2019, 350 patients were included for retrospective cohort review based on documented recovery data defined as follow up appointment PRN (as needed) or begin return to play protocol. 221 patients were lost to follow up while 7 were excluded for concomitant skull fracture. Recovery time, patient demographic data, symptoms severity score, and injury characteristics were then analyzed for each patient.ResultsOverall, the mean time of recovery after new diagnosis of any concussion was 87.2 days. The mean time to documented recovery in sports-related concussion was 82.6 days compared to 98.5 days in non-sports related concussion. Of note, both the 5–12 and 13–18 age groups had the same mean time to recovery at 87 days.ConclusionsSports related concussion showed decreased mean time to recovery compared to non-sports related concussion. Also, age did not play a factor in time to recovery as there was no difference in the 2 age groups. This data, along with the NCAA-DOD Care Consortium showing repetitive head injury during early adolescence is unrelated to brain health as measured by specific outcome measures, has the potential to provide valuable information for future policy on child and adolescent sports.

Retethering of transected fatty filum terminales

2011 ◽  
Vol 7 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Hideki Ogiwara ◽  
Arleta Lyszczarz ◽  
Tord D. Alden ◽  
Robin M. Bowman ◽  
David G. McLone ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Simple Procedure ◽  
Demographic Data ◽  
Rare Condition ◽  
Bladder Capacity ◽  
Leg Pain ◽  
Filum Terminale ◽  
The Mean

Object Untethering of a tethered spinal cord (TSC) by transecting or removing a fatty filum terminale is a relatively simple procedure that can prevent or ameliorate neurological symptoms, and the postoperative prognosis is usually good. Progressive neurological deterioration caused by recurrent tethering has been rarely reported. The authors present their experience in cases in which a sectioned fatty filum terminale has become retethered. Methods The authors retrospectively analyzed the surgical results of pediatric patients with fatty filum terminale–TSC treated by transection of the filum. The patients' charts were reviewed for demographic data, clinical presentation, surgical therapy, and follow-up data. Results Of the 225 children who underwent TSC release by sectioning the fatty filum from 1992 to 2005, there were 6 patients (2.7%; 3 males, 3 females) in whom the fatty filum retethered. The mean age at the first diagnosis of TSC was 5.2 years (range 2 months–12.3 years). The mean duration from the first untethering procedure to retethering was 5.4 years. The mean age at the time of retethering was 10.6 years (range 7–17.5 years). Symptoms of retethering were urinary incontinence, low-back pain, difficulty walking, constipation, leg pain, and worsening foot deformity. Patients underwent cystometrography at the time retethering was indicated by increased bladder capacity, large post-void residual volume, decreased bladder capacity, increase in filling pressure, and poor sensation of filling. Magnetic resonance imaging revealed adherence of the rostral stump of the sectioned filum to the midline dorsal dural surface. All patients underwent the second untethering procedure. Four patients improved neurologically and experienced no retethering thereafter (mean follow-up period 5.5 years). Two patients experienced additional retethering after temporary improvement following the second untethering procedure. Conclusions Retethering of the spinal cord is a rare condition occurring after the sectioning of a fatty filum terminale. Awareness of this rare sequela is necessary for appropriate long-term management of TSC caused by a fatty filum terminale. Cystometrography is useful for detecting the lesion and confirming the diagnosis of retethering.

Our laparoscopic cystectomy experiences

2020 ◽  
pp. 039156032096291
Author(s):  
Merder Erkan ◽  
Can Osman ◽  
Arıman Ahmet ◽  
Polat Emre Can ◽  
Altunrende Fatih
Keyword(s):  
Robotic Surgery ◽  
Demographic Data ◽  
Operation Time ◽  
Operation Technique ◽  
Total Operation Time ◽  
Laparoscopic Cystectomy ◽  
Training And Research ◽  
Tumour Pathology ◽  
The Mean

Purpose: We aimed to present our laparoscopic cystectomy experience and demonstrate that it is a feasible technique with safe oncologic principles. Methods: Total 19 patients who underwent laparoscopic radical cystectomy and pelvic lymph node dissection (PLND) in our urology clinic (Okmeydani Training and Research Hospital) were retrospectively evaluated. Demographic data, operation technique and complications, tumour pathology and follow-up details of patients were recorded. Results: Patients ranged from 40 to 73 years, with the average age of 60.8 and female/male rate was 2/17. The mean total operation time was 375 min (range 260–500). Mean hospitalisation time of patients was 10.3 days. The mean follow-up time was 11.2 months. Conclusion: Minimally invasive approaches in urology are becoming the first line treatment by the time. Due to the high costs and limited availability, robotic surgery is still not exactly widespread in the world. Our series showed that conventional laparoscopic cystectomy is an appropriate approach until robotic surgery becomes widespread.

scholarly journals Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

2017 ◽  
Vol 42 (6) ◽  
pp. E10 ◽  
Author(s):  
Al-Wala Awad ◽  
Karam Moon ◽  
Nam Yoon ◽  
Marcus D. Mazur ◽  
M. Yashar S. Kalani ◽  
...  
Keyword(s):  
Salt Lake ◽  
Demographic Data ◽  
Salt Lake City ◽  
Cerebral Aneurysms ◽  
Flow Diversion ◽  
Single Session ◽  
Anterior Circulation ◽  
The Mean ◽  
Lake City

OBJECTIVEFlow diversion has proven to be an efficacious means of treating cerebral aneurysms that are refractory to other therapeutic means. Patients with tandem aneurysms treated with flow diversion have been included in larger, previously reported series; however, there are no dedicated reports on using this technique during a single session to treat this unique subset of patients. Therefore, the authors analyzed the outcomes of patients who had undergone single-session flow diversion for the treatment of tandem aneurysms.METHODSThe authors conducted a retrospective review of flow diversion with the Pipeline embolization device (PED) for the treatment of tandem aneurysms in a single session at 2 participating medical centers: University of Utah, Salt Lake City, Utah, and Barrow Neurological Institute, Phoenix, Arizona. Patient demographic data, aneurysm characteristics, treatment strategy and results, complications, and follow-up data were collected from the medical record and analyzed.RESULTSBetween January 2011 and December 2015, 17 patients (12 female, 5 male) with a total of 38 aneurysms (mean size 4.7 ± 2.7 mm, mean ± SD) were treated. Sixteen patients had aneurysms in the anterior circulation, and 1 patient had tandem aneurysms in the posterior circulation. Twelve patients underwent only placement of a PED, whereas 5 underwent adjunctive coil embolization of at least 1 aneurysm. One PED was used in each of 9 patients, and 2 PEDs were required in each of 8 patients. There were 2 intraprocedural complications; however, in both instances, the patients were asymptomatic at the last follow-up. The follow-up imaging studies were available for 15 patients at a mean of 7 months after treatment (216 days, range 0–540 days). The mean initial Raymond score after treatment was 2.7 ± 0.7, and the mean final score was 1.3 ± 0.7.CONCLUSIONSIn this series, the use of flow diversion for the treatment of tandem cerebral aneurysms had an acceptable safety profile, indicating that it should be considered as an effective therapy for this complicated subset of patients. Further prospective studies must be performed before more definitive conclusions can be made.

Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction in patients younger than 6 months

2021 ◽  
pp. 039156032199360
Author(s):  
Saeed Alhindi ◽  
Mohamed Mubarak ◽  
Husain Alaradi
Keyword(s):  
Operative Time ◽  
Demographic Data ◽  
Renal Ultrasound ◽  
Ultrasound Scan ◽  
Operative Duration ◽  
Operative Complications ◽  
Efficient Alternative ◽  
The Mean ◽  
Operative Ultrasound

Objective: The transverse dorsal lumbotomy approach provides excellent exposure to the PUJ and causes minimal tissue damage. In this study, we assess the efficacy of dorsal lumbotomy in PUJ obstruction in children younger than 6 months. Methods: All children less than 6 months who were managed with the dorsal lumbotomy approach between 2009 and 2017 were reviewed prospectively. Data included: demographic data, pre/post-operative renal ultrasound scan with SFU grading and RDS, operative time, post-operative complications, and follow up results. Results: A total of 42 children with a mean age of 4.4 ± 1 months were included. On pre-operative RDS, all patients had an obstructive pattern and a SRF of 30.3 ± 9.3. The mean operative duration was 49 min and analgesia was minimal. Post-operative ultrasound at 6 months showed an improvement in hydronephrosis ( p < 0.05) and a mean SRF of 39.3 ± 6.1 ( p < 0.001). Conclusion: Transverse dorsal lumbotomy approach is a safe and efficient alternative in patients less than 6 month.

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