scholarly journals Transoral per punctum excision of an impacted parotid duct stone of unfavorable direction: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammad Waheed El-Anwar ◽  
Karima Gaid ◽  
Mohamed Hassan Nasr ◽  
Noura Abd El Aziz Ahmed

Abstract Background In the literature, the reported parotid duct stones that did not respond to the conservative measures are few. The present work reported and described the diagnosis and treatment of a case of impacted parotid duct stone that was surgically removed through minimally invasive transoral per punctum approach. Case presentation On examination of a 27-year-old male with left intermittent parotid swelling and pain for 1 year, a stone was palpated in the left buccal mucosa region near the orifice of the parotid duct. Ultrasonography (US) showed left Stensen’s duct distal stone. Under general anesthesia and oral intubation, the stone measuring about 1 cm in length was felt transversely located (directed at a right angle with the orifice of the duct). A small mucosal incision was done at the upper lateral part of the punctum; pus came out, and then the stone bulged from the orifice and was pushed outside. Recovery was event-less; postoperative paracetamol was sufficient to relieve pain, and the patient was discharged a few hours after the surgery. Conclusion The transoral per punctum excision of an impacted parotid duct stone appears to be a reliable minimally invasive effective and safe procedure. The unfavorable direction of the parotid duct stone might be a cause of failure of the conservative treatment for this stone.

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Nur Eliana Ahmad Tarmizi ◽  
Suhana Abdul Rahim ◽  
Avatar Singh Mohan Singh ◽  
Lina Ling Chooi ◽  
Fei Ming Ong ◽  
...  

Abstract Background Salivary gland calculi are common in adults but rare in the paediatric population. It accounts for only 3% of all cases of sialolithiasis. Parotid ductal calculus is rare as compared to submandibular ductal calculus. Case presentation A 3-year-old boy presented with acute painful right parotid swelling with pus discharge from the Stensen duct. Computed tomography revealed calculus obstructing the parotid duct causing proximal ductal dilatation and parotid gland and masseter muscle oedema. The child was treated with conservative measures, and subsequently the swelling and calculus resolved. Conclusions Small parotid duct calculus in children may be successfully treated with conservative measures which obviate the need for surgery. We discuss the management of parotid sialolithiasis in children and conduct literature search on the similar topic.


2021 ◽  
Author(s):  
Paolo di Russo ◽  
Arianna Fava ◽  
Lorenzo Giammattei ◽  
Thibault Passeri ◽  
Atsushi Okano ◽  
...  

Abstract BACKGROUND Extended endoscopic endonasal approaches (EEAs) have progressively widened the armamentarium of skull base surgeons. In order to reduce approach-related morbidity of EEAs and closure techniques, the development of alternative strategies that minimize the resection of normal tissue and alleviate the use of naso-septal flap (NSF) is needed. We report on a novel targeted approach to the clivus, with incision and closure of the mucosa of the rostrum, as the initial and final step of the approach. OBJECTIVE To present an alternative minimally invasive approach and reconstruction technique for selected clival chordomas. METHODS Three cases of clival chordomas illustrating this technique are provided, together with an operative video. RESULTS The mucosa of the rostrum is incised and elevated from the underlying bone, as first step of surgery. Following tumor resection with angled scope and instruments, the mucosa of the sphenoid sinus (SS) is removed and the tumor cavity and SS are filled with abdominal fat. The mucosal incision of the rostrum is then sutured. A hangman knot is prepared outside the nasal cavity and tightened after the first stitch and a running suture is performed. CONCLUSION We propose, in this preliminary report, a new targeted approach and reconstruction strategy, applying to EEAs the classic concept of skin incision and closure for transcranial approaches. With further development in the instrumentations and visualization tools, this technique may become a valuable minimally invasive endonasal approach for selected lesions.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 194-194
Author(s):  
Henner M Schmidt ◽  
Diana Vetter ◽  
Christoph Gubler ◽  
Piero Valli ◽  
Bernhard Morell ◽  
...  

Abstract Background Anastomotic leak (AL) remains a major cause of morbidity in upper-GI surgery. In many centers, endoluminal vacuum drainage (EVD) has become the mainstay of therapy for AL after esophageal and gastric resections. A new idea is to use the EVD technology in a preemptive setting. In this context, we present a case series of patients that received PEVD upon completion of the anastomosis during esophago-gastric surgery. Methods Intraoperative PEVD was performed in 10 consecutive patients undergoing minimally invasive esophagectomy with cervical (n = 1) or high intrathoracic (n = 6) anastomosis, and open transhiatally extended (n = 1) or minimally invasive (n = 2) total gastrectomy. The EVD device was removed after three to six (mean 4) days, and the anastomosis was endoscopically inspected for ischemia and AL. Additional contrast radiography, computed tomography, or gastroscopy to exclude AL was performed in seven patients. Primary endpoints in this retrospective series was AL; secondary endpoints were the postoperative morbidity measured by the Clavien-Dindo (CD) classification and the comprehensive complication index (CCI), all at 30 days after surgery. Results Perioperative mortality was 0% with uneventful anastomotic healing in all patients of this series (AL rate 0%, anastomotic stenosis 0%). There were no adverse events attributable to PEVD. None of the patients experienced major morbidity (> CD grade IIIa) during the postoperative course. The median postoperative ICU and hospital stay was 1 (IQR 1-1.75) and 14 (IQR 12-16) days, respectively. Five patients (50%) developed at least one complication, mostly related to infection (2 patients) and pulmonary events (2 patients). The mean CCI at 30 days after surgery was 13.7 (range 0-39.5). Conclusion PEVD appears to be a safe procedure that may emerge as a groundbreaking technology in patients undergoing esophageal or gastric resection. Further research is needed to elucidate the true potential of this technique. Disclosure All authors have declared no conflicts of interest.


2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1
Author(s):  
Martin H. Pham ◽  
Andre M. Jakoi ◽  
Patrick C. Hsieh

Lumbar interbody fusion is an important technique for the treatment of degenerative disc disease and degenerative scoliosis. The oblique lumbar interbody fusion (OLIF) establishes a minimally invasive retroperitoneal exposure anterior to the psoas and lumbar plexus. In this video case presentation, the authors demonstrate the techniques of the OLIF at L5–S1 performed on a 69-year-old female with degenerative scoliosis as one component of an overall strategy for her deformity correction.The video can be found here: https://youtu.be/VMUYWKLAl0g.


Author(s):  
Saeid Mirzai ◽  
Narutoshi Hibino ◽  
Gianluca Torregrossa ◽  
Husam H. Balkhy

The growth and advancement of minimally invasive cardiac surgery in recent years has allowed robotic and totally endoscopic procedures to become safe and effective options for the treatment of patients with various diseases of the heart. However, despite these advances, outcome data for robotic correction of congenital cardiac anomalies are scarce. This is particularly true for robotic ventricular septal defect (VSD) repair with initial experiences only recently having been published by a single group. Here, we present the case of a 29-year-old female who underwent robotic totally endoscopic VSD repair due to persistent symptoms with resolution of preoperative shunting and severe tricuspid regurgitation following surgery. This unique case adds to the limited data currently available in the literature on robotic VSD repair to show that it is a safe procedure when performed by a dedicated surgical team experienced in minimally invasive robotic cardiac surgery. We feel that, in this setting, the benefits of a robotic surgical approach can be afforded to more patients with excellent results.


Polymers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 3568
Author(s):  
Caroline Herron ◽  
Conn L. Hastings ◽  
Clodagh Herron-Rice ◽  
Helena M. Kelly ◽  
Joanne O’Dwyer ◽  
...  

A reduction in blood supply to any limb causes ischaemia, pain and morbidity. Critical limb ischaemia is the most serious presentation of peripheral vascular disease. One in five patients with critical limb ischaemia will die within six months of diagnosis and one in three will require amputation in this time. Improving blood flow to the limb, via the administration of angiogenic agents, could relieve pain and avoid amputation. Herein, chitosan is combined with β-glycerophosphate to form a thermoresponsive formulation (chitosan/β-GP) that will flow through a syringe and needle at room temperature but will form a gel at body temperature. The chitosan/β-GP hydrogel, with or without the angiogenic molecule desferrioxamine (DFO), was injected into the mouse hind limb, following vessel ligation, to test the ability of the formulations to induce angiogenesis. The effects of the formulations were measured using laser Doppler imaging to determine limb perfusion and CD31 staining to quantify the number of blood vessels. Twenty-eight days following induction of ischaemia, the chitosan/β-GP and chitosan/β-GP + 100 µM DFO formulations had significantly (p < 0.001 and p < 0.05, respectively) improved blood flow in the ischaemic limb compared with an untreated control. Chitosan/β-GP increased vessel number by 1.7-fold in the thigh of the ischaemic limb compared with an untreated control, while chitosan/β-GP + 100 µM DFO increased vessel number 1.8-fold. Chitosan/β-GP represents a potential minimally invasive treatment for critical limb ischaemia.


2005 ◽  
Vol 123 (6) ◽  
pp. 298-299 ◽  
Author(s):  
Rogério Aparecido Dedivitis ◽  
André Vicente Guimarães

CONTEXT AND OBJECTIVE: Minimally invasive video-assisted gasless thyroidectomy (MIVAT) has mainly been described in Italy and has been demonstrated to be a safe procedure with additional advantages regarding cosmetic results and postoperative outcome. The aim of this work is to analyze our preliminary results from minimally invasive video-assisted thyroidectomy. DESIGN AND SETTING: Retrospective study at the Head and Neck Surgery Service of Hospital Ana Costa, Santos. METHODS: Twelve patients underwent hemithyroidectomy and another three underwent total thyroidectomy by means of minimally invasive video-assisted thyroidectomy between June and September 2004. Gender, age, goiter volume, major diameter of the dominant nodule, duration of surgery, pain complaints during the first postoperative day, length of hospital stay, cosmetic result and complications were retrospectively analyzed. RESULTS: All the patients were women, with median age of 34. The median goiter volume was 16.5 ml, and the median major diameter of the nodule was 2.3 cm. Ten patients reported mild pain at the surgical site. The median scar size was 2.0 cm and all patients considered the cosmetic results excellent. The median duration of surgery was 55 minutes, all patients were discharged on the first postoperative day, and there were no complications. CONCLUSIONS: The outcome from minimally invasive video-assisted thyroidectomy is good in terms of cosmetic results, analgesia and postoperative recovery. The scar is shorter than in the conventional procedure.


2011 ◽  
Vol 24 (01) ◽  
pp. 50-56 ◽  
Author(s):  
M. Manassero ◽  
S. Blot ◽  
J. L. Thibaud ◽  
V. Viateau ◽  
D. Leperlier

Summary Objectives: To investigate the feasibility of a minimally invasive video-assisted (MIVA) cervical ventral slot (VS) in dogs without the use of fluoroscopy, and to report our initial clinical experiences in dogs. Methods: Two surgical approaches to an inter-vertebral disk space (IVDS) were performed in eight intact canine cadavers to determine the feasibility of MIVA-VS using the Destandau Endospine™ Device a (DED) without fluoroscopic guidance. In a subsequent clinical study, 10 client-owned dogs admitted for a Hansen type 1 disk extrusion underwent a MIVA-VS. Recorded data in both studies included: incision lengths, correct targeting of the IVDS, technical problems encountered during the procedure, and potential damage to major anatomical structures. In the 10 clinical cases, duration of the procedure and clinical outcome at five and 12 days, and after a minimum of three months were also recorded. Results: Correct exposure of the targeted IVDS was achieved in all cases. There was no major iatrogenic damage. Mean skin incision length was 39 mm and mean surgery time was 52 minutes. The technique provided increased illumination and magnification of the surgical field. Recovery was uneventful in all cases. Clincial relevance: The present study provided evidence that MIVA-VS using the DED was feasible and a relatively fast and safe procedure for the treatment of cervical disk herniation. Advantages of the technique seemed to include shorter incisions, less dissection and improved visibility.


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