scholarly journals Results of Winograd technique (wedge resection of the toenail and nail bed) in ingrown toe nail

2019 ◽  
Vol 6 (7) ◽  
pp. 2349 ◽  
Author(s):  
Aftab Ahmad Khan ◽  
Shiv Kumar
Keyword(s):  
Surgical Intervention ◽  
District Hospital ◽  
Wedge Resection ◽  
Surgical Techniques ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Nail Bed ◽  
A Prospective Study ◽  
Late Stages

Background: Ingrown toe nail is a very common condition affecting toes which causes significant morbidity. Most common reasons are improper nail trimming or a tight show wear. Early stages can be managed conservatively by warm soaks, antibiotics and analgesics, however late stages need surgical intervention. Numerous surgical techniques have been described for this condition.Methods: A prospective study was carried out in District hospital Doda from November 2015 to November 2017. Wedge resection of the toe nail and nail bed (Winograd technique) was used. Recurrence rates, complications and patient satisfaction was noted at the end of follow up at one year.Results: We operated 29 toes in 23 patients. We had 3 (10.34%) recurrences out of 29 toes operated, 2 (6.89%) patients got secondarily infected. The overall satisfaction rate in our series was 69.56%.Conclusions: Winograd technique is an easy and safe procedure, however chances of recurrence and cosmetic disfigurement should be explained to the patient during consent. 

Long-Term Follow-Up of Early Cochlear Implant Device Activation

2021 ◽  
pp. 1-11
Author(s):  
Stefanie Bruschke ◽  
Uwe Baumann ◽  
Timo Stöver
Keyword(s):  
Speech Recognition ◽  
Side Effects ◽  
Cochlear Implant ◽  
Surgical Techniques ◽  
Control Group ◽  
First Year ◽  
Safe Procedure ◽  
Sound Processor

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.

Study on spontaneous cerebrospinal fluid rhinorrhoea: its aetiology and management

2005 ◽  
Vol 119 (1) ◽  
pp. 12-15 ◽  
Author(s):  
C J Dunn ◽  
A Alaani ◽  
A P Johnson
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Queen Elizabeth Hospital ◽  
Study Group ◽  
Common Features ◽  
Csf Rhinorrhoea ◽  
The Common ◽  
Csf Leaks

The aim of this study was to identify the common features in a study group of patients with spontaneous cerebrospinal fluid (CSF) rhinorrhoea, to develop a hypothesis to explain the cause of this condition and to investigate the outcome of surgical techniques adopted to repair the leak. In this retrospective study the authors have reviewed all the cases of spontaneous CSF leaks attending and receiving treatment from the otolaryngology department of Queen Elizabeth Hospital, Birmingham, from 1992 to 2002.Of 34 patients with CSF leaks, 15 were spontaneous in nature and formed the study group. Of these 15 patients, 14 were female; with ages ranging from 37 to 70 years and a median age of 50 years. All the female patients were overweight with a body mass index (BMI) >24.9 and, of these, nine were considered obese with a BMI >30. It was attempted to identify common factors in the study group and it was evident that female sex, obesity and age played a key role in this condition.The follow-up period ranged from two to 98 months. Thirteen patients were asymptomatic but two patients remained symptomatic, one of these despite repeated surgical intervention.

scholarly journals Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

2020 ◽  
Vol 7 (4) ◽  
pp. 1031
Author(s):  
Hemangi R. Athawale ◽  
Shivaji B. Mane ◽  
Natasha Vagheriya ◽  
Prathamesh More ◽  
Taha Daginawala
Keyword(s):  
Serum Creatinine ◽  
Neurogenic Bladder ◽  
Surgical Techniques ◽  
Bladder Augmentation ◽  
Renal Outcome ◽  
Urinary Continence ◽  
Ectopic Ureter ◽  
Safe Procedure ◽  
Augmentation Cystoplasty

Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction.  Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed  creatinine-1 and BUN-1)and the serum  creatinine and BUN at the last follow up after bladder augmentation (termed  creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.

scholarly journals Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6051-6055
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Surgical Intervention ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
The Mean ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Mean Time

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

scholarly journals Preoperative Assessment and Staging of Breast Cancer: Preliminary Communication

1980 ◽  
Vol 73 (8) ◽  
pp. 561-566 ◽  
Author(s):  
A P M Forrest ◽  
R B Black ◽  
V Humeniuk ◽  
E L M Cant ◽  
R A Hawkins ◽  
...  
Keyword(s):  
Primary Tumour ◽  
Prognostic Index ◽  
Preoperative Assessment ◽  
Recurrence Rates ◽  
Follow Up Study ◽  
Prognostic Groups ◽  
Occult Metastatic Disease ◽  
Preliminary Communication ◽  
A Prospective Study

A prospective study has been carried out in 172 women to determine the sensitivity of methods to detect occult metastatic disease in the skeleton and liver. With the exception of bone scintiscans, the results of these tests bore little relationship to recurrence rates. On the other hand, knowledge of the histopathology of the lower axillary (pectoral) lymph nodes is of value in this respect. A follow-up study is also reported which confirms the importance of accurate measurements of the primary tumour clinical node status and oestrogen receptor contact of the tumour in defining prognostic groups. Elastosis (estimated in 165 tumours) did not prove to be a useful prognostic index.

scholarly journals Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence

2020 ◽  
Vol 24 (06) ◽  
pp. 627-644
Author(s):  
Iris-M. Noebauer-Huhmann ◽  
Snehansh R. Chaudhary ◽  
Olympia Papakonstantinou ◽  
Joannis Panotopoulos ◽  
Marc-André Weber ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Surgical Techniques ◽  
Soft Tissue Sarcomas ◽  
Late Complications ◽  
Treatment Modalities ◽  
Recurrence Rates ◽  
Precise Knowledge ◽  
Inflammatory Pseudotumors

AbstractSoft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations. Prerequisite is a precise knowledge of the current clinical management and surgical techniques. We review recurrence rates and treatment modalities. An adequate imaging technique is paramount, and comparison with previous imaging is highly recommended. We describe time-dependent therapy-related complications on magnetic resonance imaging compared with the spectrum of regular post-therapeutic changes. Early complications such as seromas, hematomas, and infections, late complications such as edema and fibrosis, and inflammatory pseudotumors are elucidated. The appearance of recurrences and radiation-associated sarcomas is contrasted with these changes. This systematic approach in follow-up imaging of soft tissue sarcoma patients will facilitate the differentiation of post-therapeutic changes from recurrences.

Melanoma of the External Ear

1997 ◽  
Vol 83 (5) ◽  
pp. 814-817 ◽  
Author(s):  
Aldo Bono ◽  
Cesare Bartoli ◽  
Andrea Maurichi ◽  
Daniele Moglia ◽  
Gabrina Tragni
Keyword(s):  
Local Recurrence ◽  
Primary Closure ◽  
Wedge Resection ◽  
Tumor Thickness ◽  
Safe Procedure ◽  
External Ear ◽  
Partial Amputation ◽  
Clinical Records ◽  
And Cartilage

Aims and background Melanoma of the external ear is a rare disease, and its management is controversial. To address this problem, we reviewed the data concerning the patients observed at our Institution. Methods We retrospectively reviewed the clinical records of the 20 patients bearing primary ear melanoma observed over a period of about 20 years at the Istituto Nazionale Tumori of Milan. Results Initial evaluation of the patients revealed 7 stage I, 12 stage II and 1 stage III. The thickness of the tumors varied from 0.39 to 6.62 mm. Fourteen patients underwent a wedge resection of the skin and cartilage with primary closure, and 6 patients had a partial amputation of the ear. In 8 cases the section was performed at about 1 cm from the border of the tumor, in 6 cases at about 0.5 cm, and in 6 cases at more than 1 cm. The average follow-up was 57 months (range, 1-18 years). Since there was no local recurrence, it could not be related to type and extent of the local resection performed. In contrast, the development of metastases was related to tumor thickness. Conclusions A conservative excision with margins of 1 cm can be a safe procedure for invasive ear melanoma, irrespective of tumor thickness. Like melanomas of other sites, the prognosis is linked to the thickness of the tumor.

Abstract WP352: Clinical Outcomes of Patients Undergoing BrainPath-assisted Evacuation of Intracerebral Hematomas

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Min Lang ◽  
Alex M Witek ◽  
Nina Z Moore ◽  
Mark D Bain
Keyword(s):  
Clinical Outcomes ◽  
Medical Management ◽  
Surgical Intervention ◽  
Cleveland Clinic ◽  
Surgical Techniques ◽  
Surgical Morbidity ◽  
Prospective Data ◽  
Minimally Invasive Access ◽  
Better Than

Introduction: Multiple clinical trials have failed to show that surgical intervention leads to better outcomes than medical management for patients with intracerebral hemorrhage (ICH). Newer and less invasive surgical techniques have been reported to be safe and technically effective for evacuation of ICH. The purpose of this study is to evaluate clinical outcomes following ICH evacuation using the BrainPath system (NICO, Indianapolis, IN), a tool that allows minimally invasive access to the subcortical space. Methods: IRB-approved prospective data were collected on patients who underwent ICH evacuation using BrainPath at the Cleveland Clinic from August 2013 to April 2016. Glasgow Coma Score (GCS) was collected upon admission and discharge. NIH stroke score (NIHSS) and modified Rankin score (mRS) were collected upon admission and discharge, and at the 3- and 6-month months follow-up visits. Results: Thirty-five patients underwent BrainPath-assisted ICH evacuation, with a mean age of 57 ± 16 years and average ICH volume of 50.4 ± 23.5mL. Complications included two patients requiring re-operation due to hematoma re-accumulation (6%), both of whom had serum creatinine greater than 1.5, and one case of wound infection (3%). Eight (23%) patients died during the follow-up period, of which four (11%) died within 30 days of hemorrhage. GCS was 10.1 ± 3.7 on admission and improved to 11.9 ± 2.9 at discharge. NIHSS of surviving patients at pre-operation, discharge, 3-month follow-up, and 6-month follow-up were 18.6 ± 7.7 (n=35), 19.0 ± 8.7 (n=26), 7.8 ± 5.9 (n=19), and 3.7 ± 3.8 (n=12), respectively. mRS at pre-hemorrhage baseline, 3-month follow-up, and 6-month follow-up was 0.7 ± 1.2 (n=35), 4.3 ± 1.5 (n=30), and 3.9 ± 1.9 (n=26), respectively. Conclusions: Evacuation of ICH using BrainPath is associated with acceptable rates of surgical morbidity. The 30-day mortality rate was better than expected based on admission ICH scores. Patients showed improvement in GCS between admission and discharge, and they showed improvement in NIHSS and mRS at three and six months postoperatively. A comparative study is needed to investigate whether surgical evacuation using this technique results in improved clinical outcomes compared to medical management.

SURGERY FOR CONVEXITY MENINGIOMAS

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 427-434 ◽  
Author(s):  
Andrew P. Morokoff ◽  
Jacob Zauberman ◽  
Peter M. Black
Keyword(s):  
Recurrence Rate ◽  
Malignant Tumors ◽  
Surgical Techniques ◽  
Senior Author ◽  
Neurological Deficits ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Complete Excision ◽  
Image Guided

ABSTRACT OBJECTIVE Meningiomas that occur over the convexity of the brain are the most common meningiomas, but little has been published about their contemporary management. We aimed to analyze a large series of convexity meningiomas with respect to surgical technique, complication rates, and pathological factors leading to recurrence. METHODS We retrospectively reviewed 163 cases of convexity meningiomas operated on in our institution by the senior author (PMB) between 1986 and 2005. The median follow-up time was 2.3 years (range, 1–13 yr). RESULTS Convexity tumors represented 22% of all meningiomas operated on. There was a female:male ratio of 2.7:1. Median age was 57 years (range, 20–89 yr). Image-guided surgery was used on all cases in the last 5 years. The 30-day mortality rate was 0%. The incidence of new neurological deficits was 1.7%, and the overall complication rate was 9.4%. The pathology of the tumors was benign in 144 (88.3%), atypical in 16 (9.8%), and anaplastic/malignant in 3 (1.8%). In six of the cases designated “benign,” there were borderline atypical features. The 5-year recurrence rate for benign meningiomas was 1.8%, atypical meningiomas 27.2%, and anaplastic meningiomas 50%. The two cases of benign tumor recurrences involved tumors with borderline atypia and high MIB-1 indices. The borderline atypical cases had a 5-year recurrence-free survival rate of only 55.9%, more closely approximating that of tumors designated “atypical.” CONCLUSION Convexity meningiomas can be safely removed using modern image-guided minimally invasive surgical techniques with a very low operative mortality. Benign convexity meningiomas having a Simpson Grade I complete excision have a very low recurrence rate. The recurrence rates of atypical and malignant tumors are significantly higher, and borderline atypical tumors should be considered to behave more like atypical rather than benign lesions. Longer-term follow-up data are needed to more accurately determine the recurrence rates of benign meningiomas.

scholarly journals A Systematic Literature Review to Compare Clinical Outcomes of Different Surgical Techniques for Second Branchial Cyst Removal

2021 ◽  
pp. 000348942110240
Author(s):  
Sebastiaan Meijers ◽  
Rutger Meijers ◽  
Erwin van der Veen ◽  
Maaike van den Aardweg ◽  
Hanneke Bruijnzeel
Keyword(s):  
Surgical Techniques ◽  
Postoperative Recurrence ◽  
Branchial Arch ◽  
Conventional Technique ◽  
Surgical Removal ◽  
Complication Rates ◽  
Recurrence Rates ◽  
New Treatment ◽  
Meta Analyses

Objective: During the last 2 decades, new treatment methods have been developed for the surgical removal of second branchial cysts which result in less visible scars. The aim of this systematic review is to assess which surgical technique for second branchial arch cyst removal results in the lowest complication and recurrence rates with the highest scar satisfaction. Methods: Two authors systematically reviewed the literature in the Cochrane, PubMed, and EMBASE databases (search date: 1975 to December 2nd, 2020) to identify studies comparing surgical outcomes of second branchial arch cyst removal. Authors appraised selected studies on directness of evidence and risk of bias. Results are reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Out of the 2442 retrieved articles, 4 articles were included in the current review including a total of 140 operated cysts. Only 2 studies included pre-operatively infected cysts. Follow up ranged from 3 to 24 months. Complication rates ranged from 0 to 27.3% (conventional: [0–10.4%]; endoscopic/retro-auricular: [0–27.3%]). None of the patients presented with postoperative recurrence. Significantly higher scar satisfaction was found in adult patients who underwent endoscopic or retro-auricular hairline incision cyst removal. Conclusion: No recurrence of disease occurred during (at least) 3 months of follow up using either conventional surgery or endoscopic/retro-auricular techniques. Although more (temporary) complications occur using endoscopic and retro-auricular techniques, patients report a significantly higher scar satisfaction 3 to 6 months after surgery in comparison to the conventional technique. Future studies are needed to support these findings.

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