High-frequency radio wave electrocautery in modified Hotz operations for epiblepharon correction

AbstractTo report the experience and advantageous effects of high-frequency radio wave electrocautery in modified Hotz operations for epiblepharon, We reviewed the records of all pediatric patients who underwent a modified Hotz operation with the use of high-frequency radio wave electrocautery (Ellman Surgitron Dual Frequency RF S5; Ellman International, Inc, Hewlett, NY) for epiblepharon between March 2016 and September 2019 at Korea University Guro Hospital. We evaluated the success rate, complications, recurrence rate and degree of satisfaction of our technique. Information from the medical records was collected, including demographics, ocular symptoms, severity of keratopathy, operation time, success/recurrence rate, and complications. 133 patients (98.52%) showed good correction of epiblepharon without complications or unpleasant cosmetic problems during 3 months of median follow-up period. Two patients (1.48%) showed recurrent corneociliary touch, but the degree was very mild and re-operation was not performed. One patient showed mild ectropion on his left lower eyelid, but the patient recovered well without operation. For complications, suture abscess and granulation were the most common, 3 cases in each, but all of those were temporary and resolved with conservative management. The approach with electrocautery for epiblepharon allows precise and fast incision of the lower eyelid, little bleeding, and minimal scarring. Surgical outcomes associated with the modified Hotz operation with electrocautery were consistent with previous studies.

Download Full-text

Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

International Eye Research ◽

10.18240/ier.2021.03.01 ◽

2021 ◽

Vol 2 (3) ◽

pp. 123-126

Author(s):

Tian-Yu Wang ◽

◽

Min Yang ◽

Yi Zhang ◽

Zhao-Yang Wang ◽

...

Keyword(s):

Recurrence Rate ◽

Case Series ◽

Operation Time ◽

Recurrence Time ◽

Conjunctival Autograft ◽

Long Term Follow Up ◽

Pterygium Surgery ◽

Limbal Conjunctival Autograft ◽

Primary Pterygium

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

Download Full-text

Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique

Archives of Plastic Surgery ◽

10.5999/aps.2020.00220 ◽

2020 ◽

Vol 47 (4) ◽

pp. 347-353

Author(s):

Emine Malkoc Sen ◽

Kubra Ozdemir Yalcinsoy

Keyword(s):

Recurrence Rate ◽

Intraoperative Complications ◽

Case Series ◽

Lower Eyelid ◽

New Technique ◽

Before And After ◽

A New Technique ◽

The Right ◽

Horizontal Eyelid Laxity

Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.

Download Full-text

Anal fistulotomy using radiowaves - long-term outcome

Acta chirurgica iugoslavica ◽

10.2298/aci0803115g ◽

2008 ◽

Vol 55 (3) ◽

pp. 115-118 ◽

Cited By ~ 1

Author(s):

P.J. Gupta

Keyword(s):

Postoperative Complications ◽

Recurrence Rate ◽

Postoperative Bleeding ◽

Perianal Fistula ◽

Operation Time ◽

Local Skin ◽

Long Term Outcome ◽

Stool Incontinence ◽

Early Return

OBJECTIVE: The aim of this paper was to analyze the results of treatment of anal fistulas using a radiowave device retrospectively. METHODS: Between 2000 and 2008, 976 patients were operated on for perianal fistula. A Ellman radiowave generator was used to carry out the complete surgical procedure. In the follow-up period 155 patients were lost, remaining 821 patients were analyzed in the study. The mean follow-up time was 6.8 years. Analyzed parameters included: postoperative complications, wound healing time, off work duration, recurrence rate and incidence of anal sphincter dysfunction. Severity of gas and stool incontinence was assessed. RESULTS: In our study, subcutaneous fistula was diagnosed in 28.1%, inter-sphincteric in 39.1%, and trans-sphincteric in 32.8%; supra-sphincteric and extra-sphincteric fistulae were not included in the study. Single-tract fistulas were present in 85.4% and multitract fistulas were present in 14.6%. Postoperative complications were noticed in 1.4% of patients, which included postoperative bleeding, abscess formation, premature approximation of skin edges, prolapse of hemorrhoids and local skin allergic reactions. Postoperative gas and/or stool incontinence was noticed in 3.8%. The recurrence rate was 1.7%. CONCLUSIONS: Radiowave fistulotomy offers short operation time, less postoperative pain, early return to normal activity, and faster healing of the wound. The recurrence rate and continence disturbances are comparable to conventional fistulotomy procedures.

Download Full-text

Ocular Outcomes after Gold Weight and Facial Nerve Resection

Otolaryngology ◽

10.1016/j.otohns.2008.05.104 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P32-P32

Author(s):

Ali Razfar ◽

Ahmed Afifi ◽

Ernest Kelvin Manders ◽

Eugene N Myers ◽

Jonas T Johnson ◽

...

Keyword(s):

Facial Nerve ◽

Lower Eyelid ◽

Upper Eyelid ◽

Ocular Symptoms ◽

Gold Weight ◽

The Mean ◽

Eye Closure ◽

Mean Time

Objective 1) To assess the effectiveness of acute gold weight placement following facial nerve resection. 2) To determine the role of concomitant lower eyelid procedures. Methods 22 patients who received an upper eyelid gold weight at the time of parotidectomy and facial nerve resection were retrospectively reviewed (mean follow-up: 23 months). Outcomes included the assessment of eye closure, gold weight complications (i.e., extrusion, need to upsize weight), ectropion, and need for tarsal strip procedure. Results The range of gold weight size used was 1–1.4 (g), where 1.2 g was the predominant size used (18/22). 12 patients (12/22, 54.5%) presented with ocular symptoms following gold weight placement. Within these 12 patients, 9 presented with lower lid ectropion, 5 with lagopthalmos, and 6 with corneal exposure. 9 of the 12 patients subsequently received a tarsal strip procedure. The mean time to lower eyelid procedure was 14.2 months (range: 0–61) following gold weight placement. 6 patients, in addition to a gold weight, also underwent a static sling to the midface at the time of facial nerve resection. None of these 6 patients received subsequent lower eyelid procedure. Two patients required gold weight upsizing. Two patients required weight removal because of exposure. Conclusions Insertion of 1.2 gm upper eyelid weight with concomitant placement of midface sling is recommended at the time of acute facial nerve resection. Due to the need to tighten the lower eyelid in a majority of patients, we now also recommend performing a tarsal strip procedure at the time of facial nerve resection.

Download Full-text

Intraoperative, postoperative and long-term oncosurgical safety of therapeutic mammaplasty

Orvosi Hetilap ◽

10.1556/oh.2013.29660 ◽

2013 ◽

Vol 154 (33) ◽

pp. 1291-1296 ◽

Cited By ~ 1

Author(s):

László Romics Jr. ◽

Sophie Barrett ◽

Sheila Stallard ◽

Eva Weiler-Mithoff

Keyword(s):

Recurrence Rate ◽

Tumour Size ◽

Breast Conservation ◽

Malignant Lesion ◽

Surgical Techniques ◽

Incomplete Resection ◽

Immediate Reconstruction ◽

Oncological Safety

Introduction: (Pre)malignant lesion in the breast requiring mastectomy conventionally may be treated with breast conservation by using oncoplastic breast surgical techniques, which is called therapeutic mammaplasty. However, no reliable data has been published so far as regards the oncological safety of this method. Aim: The aim of the authors was to analyse the oncological safety of therapeutic mammaplasty in a series of patients. Method: 99 patients were treated with therapeutic mammaplasty and data were collected in a breast surgical database prospectively. Results were analysed with respect to intraoperative, postoperative and long-term oncological safety. Results: Incomplete resection rate was 14.1%, which correlated with tumour size (p = 0.023), and multifocality (p = 0.012). Time between surgery (therapeutic mammaplasty) and chemotherapy was similar to time between conventional breast surgeries (wide excision, mastectomy, mastectomy with immediate reconstruction) and chemotherapy (mean 29–31 days; p<0.05). Overall recurrence rate was 6.1%, locoregional recurrence rate was 2% during 27 month (1–88) mean follow-up. Conclusions: Since literature data are based on relatively short follow-up and low patient number, it is highly important that all data on therapeutic mammaplasty is collected in a prospectively maintained breast surgical database in order to determine true recurrence after long-follow-up. Orv. Hetil., 2013, 154, 1291–1296.

Download Full-text

Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas

Journal of Neurosurgery ◽

10.3171/2010.8.gks10977 ◽

2010 ◽

Vol 113 (Special_Supplement) ◽

pp. 21-27 ◽

Cited By ~ 5

Author(s):

Hyun Ho Jung ◽

Jong Hee Chang ◽

Kum Whang ◽

Jin Soo Pyen ◽

Jin Woo Chang ◽

...

Keyword(s):

Gamma Knife ◽

Cavernous Sinus ◽

Transarterial Embolization ◽

Gamma Knife Surgery ◽

Low Flow ◽

Close Monitoring ◽

Arteriovenous Fistulas ◽

Ocular Symptoms ◽

Dural Arteriovenous Fistulas

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

Download Full-text

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.13 ◽

2011 ◽

pp. 100-104

Author(s):

Thi Thu Nguyen ◽

Viet Hien Vo ◽

Thi Em Do

Keyword(s):

Success Rate ◽

Key Words ◽

Triamcinolone Acetonide ◽

Lower Eyelid ◽

Upper Eyelid ◽

Interventional Trial ◽

The Mean ◽

First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

Download Full-text

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.14 ◽

2011 ◽

pp. 114-118

Author(s):

Nhu Hiep Pham ◽

Huu Thien Ho ◽

Anh Vu Pham ◽

Van Nghia Tran

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

Central Hospital ◽

Surgical Department ◽

A New Technique ◽

Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

Download Full-text

Characteristics and recurrence of pterygium in Saudi Arabia: a single center study with a long follow‐up

BMC Ophthalmology ◽

10.1186/s12886-021-01960-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Waleed Alsarhani ◽

Saeed Alshahrani ◽

Mahmood Showail ◽

Nawaf Alhabdan ◽

Osama Alsumari ◽

...

Keyword(s):

Mitomycin C ◽

Recurrence Rate ◽

Dry Eye ◽

Amniotic Membrane ◽

Univariate Analysis ◽

Dry Eye Disease ◽

Eye Disease ◽

First Year ◽

Conjunctival Autografting

Abstract Background This study described the clinical features of patients with pterygium and analyzed the recurrence rate of conjunctival autografting alone, conjunctival autografting combined with intraoperative mitomycin C, and amniotic membrane grafting. Methods A retrospective cohort study of primary pterygium was conducted between January 2017 and February 2020. Factors associated with pterygium severity and recurrence were analyzed by univariate analysis and logistic regression models. Results The study included 292 patients with an average age of 53.3 ± 14.1 years, while the number of operated cases was 94. Pterygia involving the cornea were observed in 55 % of the cases. The overall rate of recurrence for the three procedures was 17 %. The average time of recurrence was 14.2 ± 11.9 months, with 37 % of the recurrences occurring after the first year. The only factor associated with a significant risk of recurrence was dry eye disease in both univariate (p = 0.021) and multivariate analysis (p = 0.026). The recurrence rates following conjunctival autografting with and without mitomycin C were 15.6 and 15.8 %, respectively. The recurrence rate following the amniotic membrane graft was twofold (OR= 2.02) (27 %) that following the conjunctival autograft (15.8 %). Conclusions The only factor associated with the recurrence of pterygium was dry eye disease. More than one-third of recurrences developed after the first year, which stresses the importance of a long follow-up. The recurrence rate in our study following conjunctival graft was slightly higher compared to the literature mainly due to differences in study areas, populations, and follow-up periods.

Download Full-text

Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽

10.1186/s12893-021-01255-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chunxiao Wang ◽

Yao Zhang ◽

Xiaojie Tang ◽

Haifei Cao ◽

Qinyong Song ◽

...

Keyword(s):

Blood Loss ◽

Learning Curve ◽

Clinical Outcomes ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Operation Time ◽

Operation Duration ◽

The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

Download Full-text