scholarly journals Brown Jaw Tumors: challenges and outcomes

2017 ◽  
Vol 4 (11) ◽  
pp. 3586
Author(s):  
Tarek Elsayed Ftohy Abdelrahman
Keyword(s):  
Head And Neck ◽  
Giant Cell ◽  
Serum Calcium ◽  
Clinical Examination ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Osteolytic Lesions ◽  
Brown Tumors

Background: Brown tumors are very rare giant cell lesions that arise as a result of hyperparathyroidism, brown tumors rarely affect the mandible and maxilla and its diagnosis and treatment is very challenging and needs a high index of suspicion.Methods: Retrospective chart review of nine cases diagnosed as brown jaw tumors treated in maxillofacial, head and neck surgery unit, department of surgery, Sohag University hospital.Results: They were 9 patients, 3 males and 6 females with a mean age of 43.3 years. Lesions were located in the mandible (4 cases), maxilla (3 cases), both mandible and maxilla (2 cases). The main presentation was a mass lesion. Clinical examination and serum parathormone, serum calcium, serum phosphorus, neck ultrasonography, parathyroid scan was used for diagnosis. Cases did excision with parathyroidectomy. There was no recurrence during a mean follow up period of 9.3 months. All patients had satisfactory results.Conclusions: All cases with osteolytic lesions in mandible or maxilla the possibility of brown tumors should be kept in mind especially if there is any manifestation of hyperparathyroidism. This report will aid in the recognition and treatment of the jaw brown tumors.

Does Successful Segmental Tracheal Resection Require Releasing Maneuvers?

2005 ◽  
Vol 133 (3) ◽  
pp. 372-376 ◽  
Author(s):  
Albert L. Merati ◽  
Anthony A. Rieder ◽  
Nalin Patel ◽  
Debra L. Park ◽  
Doug Girod
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Study Design ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Tertiary Hospital ◽  
Tracheal Resection ◽  
Swallowing Dysfunction ◽  
Resection And Anastomosis

OBJECTIVES: Tracheal resection is a well-established option for the management of airway stenosis. Releasing maneuvers have been described to reduce anastomotic tension. The aim of this study is to report on a series of tracheal resections performed without the use of these maneuvers. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary hospital. METHODS: All patients undergoing tracheal resection by the first author over a 6-year period were reviewed. RESULTS: Patients (n = 17; 7 men and 10 women, ages 23-76) were managed with tracheal resection and anastomosis without stenting or postoperative tracheotomy. 16/17 (94%) patients had successful treatment of their stenosis. 1/17 (6%) failed and 1/17 (6%) required dilation. There was no postoperative swallowing dysfunction. CONCLUSIONS: Segmental tracheal resection without releasing maneuvers was successful in 16/17 (94%) patients. SIGNIFICANCE: Though extrapolation from this series may be limited, future practitioners may consider forgoing additional releasing maneuvers for tracheal resection in many cases. © 2005 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.

Defining Success of Parathyroidectomy in Hyperparathyroidism

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P36-P36 ◽  
Author(s):  
Yalon Dolev ◽  
Martin J Black ◽  
Michael P Hier ◽  
Michael Tamilia ◽  
Richard J Payne
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Tertiary Care Center ◽  
The Mean ◽  
Normal Calcium

Objective To clearly define what constitutes successful parathyroidectomy in patients with primary hyperparathyroidism and to review our institution's results. Methods A retrospective chart review was conducted for consecutive patients who underwent parathyroidectomy at a university-affiliated tertiary care center between January 1998 and February 2006. Intraoperative pre- and post-excision PTH levels were recorded. PTH and calcium levels were recorded at 3 – 6 month intervals in the first 2 years and then yearly. Results 84 patients were analyzed. 50 (60%) had normal calcium and normal PTH levels following surgery, 28 (33%) had normal calcium and elevated PTH following surgery, and 6 (7%) had both elevated calcium and PTH. The mean follow-up time was 2.23 years, with a range of 0.25 to 5 years. Conclusions Surgery was successful, as indicated by normocalcemia, in 78 patients (93%). Of these 78 patients, 28 (33%) developed persistent PTH elevation without developing hypercalcemia. Other studies have studied this subgroup of patients with normalized post-operative calcium and consistently elevated PTH levels and noted that these new set points persist. Consequently, successful parathyroidectomy should be defined by serum calcium and not PTH levels.

Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

2021 ◽  
pp. 019459982110089
Author(s):  
Quinn Dunlap ◽  
James Reed Gardner ◽  
Amanda Ederle ◽  
Deanne King ◽  
Maya Merriweather ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Surgical Complications ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Continuous Variables ◽  
Significant Difference ◽  
History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

Cholecystectomy for Biliary Hyperkinesia

2019 ◽  
Vol 85 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Joshua Gazzetta ◽  
Betty Fan ◽  
Paul Bonner ◽  
John Galante
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Chart Review ◽  
Gallbladder Disease ◽  
Retrospective Chart Review ◽  
Biliary Colic ◽  
Study Cohort ◽  
Final Pathology ◽  
Pathology Reports ◽  
Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

Kasai Procedure in Patients Older Than 90 Days: Worth a Cut

2021 ◽  
Author(s):  
Marie Uecker ◽  
Joachim F. Kuebler ◽  
Nagoud Schukfeh ◽  
Eva-Doreen Pfister ◽  
Ulrich Baumann ◽  
...  
Keyword(s):  
Treatment Option ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Primary Treatment ◽  
Inclusion Criteria ◽  
Bridge To Transplant ◽  
Kasai Procedure ◽  
Native Liver ◽  
Native Liver Survival

Abstract Introduction Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE. Materials and Methods A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90–133 days). Results Postoperative jaundice clearance (bilirubin < 2 mg/dL) at 2-year follow-up was achieved in three patients (27%). Eight patients (73%) received a liver transplant at a mean of 626 days (range: 57–2,109 days) after KPE. Four patients (36%) were transplanted within 12 months post-KPE. Two patients died 237 and 139 days after KPE due to disease-related complications. One patient is still alive with his native liver, currently 10 years old. Conclusion Even when performed at an advanced age, KPE can help prolong native-liver survival in BA patients and offers an important bridge to transplant. In our opinion, it continues to represent a viable primary treatment option for late-presenting infants with BA.

scholarly journals 763. 30 Day Readmission Outcomes in Patients Over 80 Years of Age Enrolled in an Outpatient Parenteral Antibiotic Therapy (OPAT) Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S339-S340
Author(s):  
Kathleen R Sheridan ◽  
Joshua Wingfield ◽  
Lauren McKibben ◽  
Natalie Clouse
Keyword(s):  
Readmission Rate ◽  
Chart Review ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Model Of Care ◽  
Readmission Rates ◽  
Parenteral Antibiotic ◽  
Patient Demographics

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.

scholarly journals Unpacking Loss to Follow-Up Among HIV-Infected Women Initiated on Option B+ In Northern Tanzania: A Retrospective Chart Review

2019 ◽  
Vol 3 (1) ◽  
pp. 6-15
Author(s):  
Festo Mazuguni ◽  
Boaz Mwaikugile ◽  
Cody Cichowitz ◽  
Melissa Watt ◽  
Amasha Mwanamsangu ◽  
...  
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Loss To Follow Up ◽  
Northern Tanzania

scholarly journals Comparison of corrected serum calcium changes following thyroid and non thyroid neck surgeries

2018 ◽  
Vol 6 (1) ◽  
pp. 1-4
Author(s):  
Saloni Sinha ◽  
Dharma Kanta Baskota
Keyword(s):  
Head And Neck ◽  
Serum Calcium ◽  
Recovery Room ◽  
Neck Surgery ◽  
University Teaching ◽  
The Mean ◽  
Mean Differences ◽  
Operative Recovery ◽  
Prospective Longitudinal ◽  
Main Factor

Objective: To compare the corrected serum calcium changes following thyroid and non thyroid neck surgeries.Material and Methods: It was a prospective, longitudinal and comparative study, done in Ganesh Man Singh Memorial Academy of ENT and Head and Neck Studies, Tribhuvan University, Teaching hospital, Kathmandu, Nepal. Convenient sample size was taken of patients undergoing thyroid and non thyroid neck surgeries under general anaesthesia, between 1st November 2009 to 30th April 2011.Result: Total 87 cases were included which comprises 41 cases of thyroid and 46 cases of non thyroid neck lesions. Total females in thyroid cases were 39 out of 41 and in non thyroid cases 25 out of 46. The mean corrected calcium in thyroid cases were 2.04 ± 0.07, 1.75 ± 0.26, 1.92 ± 0.16 and 2.00 ± 0.07 in pre-operative, recovery room (immediate post-operative), post-operative day-1(POD 1) and post-operative day-4(POD- 4) respectively. The mean calcium changes in non thyroid cases were 2.04 ± 0.09, 1.89 ± 0.19, 1.94 ± 0.13 and 1.99 ± 0.04 in pre-operative period, recovery room (immediate post-operative), post-operative day-1(POD-1) and post-operative day-4 (POD- 4) respectively. In both thyroid and non thyroid group, the calcium drop was statistically significant  (< 0.05) in recovery. Rest were not significant statistically. The mean differences from pre-operative to recovery and preoperative to POD-1 corrected calcium changes were also significant in both thyroid and non thyroid groups. The mean difference between preoperative to POD-4 was not significant in both groups.Conclusion: After comparing the corrected serum calcium changes following thyroid and non thyroid neck surgeries, the transient post-operative hypocalcaemia is not a thyroid surgery dependent phenomenon. Haemodilution is the main factor for hypocalcaemia in immediate postoperative period in all major neck surgeries.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015 

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