scholarly journals A prospective analysis of post mastoidectomy cavity complications

2019 ◽  
Vol 5 (6) ◽  
pp. 1566
Author(s):  
Dhanya Rajan ◽  
Susan James
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Analytical Study ◽  
Disease Process ◽  
Mastoid Cavity ◽  
Prospective Analysis ◽  
Essential Step ◽  
Set Up ◽  
Process Reconstruction

<p class="abstract"><strong>Background:</strong> The main aims of surgical treatment of chronic middle ear suppuration are elimination of disease process, reconstruction of hearing mechanism and prevention of complications. The objective of this study is to find out the incidence of cavity problems after open cavity mastoidectomy. To evaluate perioperative factors involved in the causation of cavity problems.</p><p class="abstract"><strong>Methods:</strong> A prospective analytical study was conducted among 78 patients came for open mastoidectomy admitted in department of ENT. Each patient had a follow up upto three months at twice weekly intervals. In this study a borderline healing period of three months (12 weeks) was given for the complete epithelialisation of an open mastoid cavity. SPSS was used for analysis.  </p><p class="abstract"><strong>Results:</strong> The incidence of postoperative cavity problems in our set up is 26.92%. Youngest patient to undergo mastoidectomy was a 4-year-old boy. The youngest patient who presented with cavity problem was of 7years. 59 (75.64%) had sclerotic mastoid and 10 (12.82%) had cellular mastoid and 9 (11.53%) had diploeic mastoid. Hence out of the 21 postoperative mastoid cavity problems, 5 cases had large postoperative cavity, 18 cases had high facial ridge, 1 case had stenosis of meatoplasty, 17 cases had exposed middle ear and eustachian tube and 17 had postoperative granulations.</p><p class="abstract"><strong>Conclusions:</strong> There should be complete exenteration of disease from the middle ear and mastoid. An adequately lowered facial ridge is an essential step to attain a dry cavity.</p>

S224 – Efficacy of Long Silastic Sheet in COM Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P150-P150
Author(s):  
Hyong-Ho Cho ◽  
Hyun-Seok Choi ◽  
Chul-Ho Jang ◽  
Yong-Bum Cho
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Middle Ear Mucosa ◽  
Hearing Result ◽  
Staged Operation ◽  
Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

scholarly journals Surgical treatment of tuberculosis of spine: Nepalese experience

2019 ◽  
Vol 1 (1) ◽  
pp. 8-20
Author(s):  
Binod Bijukachhe ◽  
Chester E. Sutterlin
Keyword(s):  
Surgical Treatment ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Disease Process ◽  
Neurological Status ◽  
Abscess Drainage ◽  
Ct Guided ◽  
Radiological Criteria ◽  
Early Return

Introduction : Spinal tuberculosis treatment goal is eradication of the disease, neurological protection, and deformity prevention. Accepted indications for conservative or surgical management of the disease are still lacking. The purpose of this study was to classify disease based on pre- and post-treatment clinical and radiological criteria to help management. Material and methods : Out of 101 patients, retrospectively reviewed between 2007 and 2015, seventy adult patients (44 males, mean age 29 years, range 16-76) were included in the study. Patients were evaluated clinically for pain, deformity and neurological status while radiological evaluation included sagittal deformity, vertebra destruction and number of vertebrae involvement. 60 patients underwent surgery (abscess drainage, 2; anterior radical debridement and fusion, 12; anterior debridement + posterior instrumentation, 26; posterior instrumentation, 20) All patients were given anti-tuberculous treatment for 12 months. Mean follow up period was 44.9 months (range: 6-108 months). Result: Pre-treatment pain (Visual analogue score, VAS 0-10, mean 7.52) improved by 0.99 at last follow up. Number of vertebrae involved ranged from 1 to 15 (mean 4.2). 38 patients had obvious clinical deformity with Cobb angle mean 36.6° (range 10°-130°). Deformity was corrected at mean of 17.5° (range: -60° to 90°) at last follow up. There were two ASIA A, eight ASIA B, five ASIA C, four ASIA D and 51 patients with ASIA E neurology at the time of presentation. One patient with ASIA A neurology remained same even after decompression while other patient died on the day of surgery. Out of 8 patients with ASIA B neurology six patients improved to ASIA E, one patient remained same and one patient deteriorated to ASIA A. In ASIA C group, three patients improved to ASIA E. One patient deteriorated to ASIA A. All four patients with ASIA D neurological status improved to ASIA E. And all 51 patients with pre-operative ASIA E status remained same but one deteriorated to ASIA C. Eight patients had deformity progression, two patients had deep vein thrombosis, two patients had superficial wound infection and one patients had recurrent cold abscess. Two patients died due to associated co-morbidities. Based upon the clinical and radiological pre- and post-operative findings; Uncomplicated spines were managed conservatively or with abscess drainage (USG or CT – guided). Complicated spines were managed with posterior instrumentation and complex spines were managed with anterior / posterior procedure (posterior only approach) Conclusion: Based upon the outcome of treatment of spinal tuberculosis, conservative treatment results in healing of the disease process with residual deformity while surgical treatment in selected cases results in early pain alleviation, spinal balance, neurologic protection and eventually early return to work.

A STUDY ON OUTCOME OF SURGICAL TREATMENT OF COMPOUND TIBIA FRACTURES BY INTRAMEDULLARY NAILING AFTER PRELIMINARY EXTERNAL FIXATION – SHORT TERM RETROSPECTIVE AND PROSPECTIVE ANALYSIS

2021 ◽  
pp. 19-21
Author(s):  
Suresh Kumar Thirugnanam ◽  
Sudhakar Ramasamy
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Prospective Analysis ◽  
Short Term ◽  
Tibia Fractures ◽  
Grade Iii

About 23% of all tibial fractures are open and most of these are Gustilo grade III. This study was done to evaluate the functional outcome of surgical treatment of compound tibia fractures by intramedullary nailing after preliminary external xation as a short term retrospective and prospective analysis. From February 2012 to November 2013, a short term retrospective and prospective analysis was done in The Institute of Orthopedics & Traumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. We did secondary interlocking nailing after preliminary external xation for grade II to grade III B open tibia fractures in 31 patients for 31 fractures (Box 1 shows the inclusion and exclusion criteria). Out of these 31 patients, we lost follow-up of 4 patients and analyzed the results with the average follow-up of 12 months and minimum follow up of 5 months. Data was tabulated and analysed using Microsoft excel 2003. Functional outcome of secondary intra medullary nailing after external xation was far better than in primary interlocking with primary closure in our institution. Although the supercial infection is there and there is delay in denitive procedure in the management of compound fractures, this can be improved by early surgical intervention, timely secondary procedures and accurate assessment of soft tissue injury. The nal outcome is mainly depends on the age of the patient, time of admission since injury, type of injury.

scholarly journals A comparison of medical treatment versus surgical treatment for the management of Otitis media with effusion

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Ahmad Rohail ◽  
Zafar Iqbal Gill ◽  
Mohammad Riaz ◽  
Shahid Imran Ali ◽  
Iqbal Hussain Butt
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Otitis Media ◽  
Patient Compliance ◽  
Otitis Media With Effusion ◽  
Random Allocation ◽  
Set Up ◽  
Complications Rate ◽  
Study Setting

Aims and objectives: This study is designed: To assess outcome of the two modes of treatment (medical and surgical) of otitis media with effusion in terms of their effectiveness and patient compliance, and to compare in terms of side effects and complications. Sample size: Forty patients who fulfilled the inclusion criteria included in the study. They were divided into two groups by random allocation of medical or surgical mode of treatment. Thus each group consisted of twenty patients. Study setting: The study was conducted in the Department of ENT Jinnah Hospital, Lahore. Results: In Medically Treated Twenty patients effusion did not resolve in most of the cases, and recovered after some time during the follow-up period. In remaining twenty patients treated surgically, there was immediate improvement in hearing in most of the patients. Conclusion: Complications rate is more in surgical treatment as compared to medical treatment. But in spite of this, surgical treatment is better option in our set-up r egarding effectiveness and patient compliance.

Intact meatal skin, canal wall down approach for difficult cochlear implantation

2009 ◽  
Vol 123 (8) ◽  
pp. 903-906 ◽  
Author(s):  
M J Carfrae ◽  
D Foyt
Keyword(s):  
Middle Ear ◽  
External Auditory Canal ◽  
Cochlear Implantation ◽  
Round Window ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Posterior Canal ◽  
Facial Recess ◽  
Canal Wall Down

AbstractIntroduction:The intact posterior meatal skin, canal wall down technique for difficult cochlear implantation provides expanded access to the middle ear for cochleostomy in cases of obscured middle-ear landmarks, limited facial recess access and limited mastoid cavity dimensions. Careful preservation of the posterior canal wall skin in this procedure obviates the need for obliteration of the middle-ear mucosa and closure of the external auditory canal.Objectives:To present a canal wall down technique for cochlear implantation, which preserves the intact posterior external auditory canal wall skin. This approach is employed when a standard facial recess cochleostomy is not possible.Methods:Three cases of intact posterior meatal skin, canal wall down cochlear implantation are presented together with long-term follow-up results. In all three cases, implantation via a facial recess approach was not possible. One patient suffered from severe cochlear otosclerosis with obliteration of the round window niche. The second patient had severe middle-ear fibrosis with encasement of all middle-ear structures and obliteration of routine landmarks. The third patient had an anterior sigmoid sinus obscuring access to the facial recess. Cochlear implantation via the canal wall down, intact posterior canal wall skin technique was successfully performed in each of these patients.Results:All three patients were successfully implanted, with full electrode insertion achieved. All patients subsequently became active implant users. One patient did suffer from a minor wound complication post-operatively, unrelated to the approach. Patient follow up ranged from four to six years.

scholarly journals Surgical Treatment of Loffler Endocarditis in an 8-Year-Old Girl

2020 ◽  
Vol 23 (6) ◽  
pp. E870-E872
Author(s):  
Zhangke Guo ◽  
Fan Fan ◽  
Pei Li ◽  
Xiaofeng Liu ◽  
Ning Ma ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Late Phase ◽  
Disease Process ◽  
Good Prognosis ◽  
Cardiac Damage ◽  
Cardiac Condition ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Stage Process

Background: Idiopathic hyper eosinophilic syndrome (HES) is a rare disease characterized by a sustained increase in eosinophilia. Heart involvement is called Loffler endocarditis. Loffler endocarditis is a serious complication of hyper eosinophilia syndrome, which is characterized by a special type of fibrotic endocarditis. Loffler endocarditis is an inflammatory cardiac condition characterized by eosinophilic infiltration in the heart. The overall prognosis for patients with Loffler endocarditis is very poor. Methods: In this article we report an 8-year-old girl who was diagnosed as having Loffler endocarditis in thrombotic phase and was successfully treated with surgery. Results: Our patient had a good prognosis during the half-year follow-up. She had no symptoms of heart failure and echocardiography findings were normal. Conclusion: The cardiac damage occurred in a three-stage process: the necrotic, thrombotic, and fibrotic stages. This unusual but sometimes life-threatening disease is often detected in the late phase, resulting in no curative strategy available to reverse the disease process. The overall prognosis of patients with Loffler endocarditis is very poor. Current treatments include anticoagulation and anti-eosinophils therapy, and surgery only in selected cases. Surgical treatment of HES in adolescents is very rare. The present case illustrates that with well-controlled peripheral eosinophilia, proper surgical treatment in selected patients can improve their prognosis in the near future but long-term follow-up is necessary.

Staging in Cholesteatoma Surgery

1993 ◽  
Vol 72 (3) ◽  
pp. 197-200 ◽  
Author(s):  
Christian Deguine
Keyword(s):  
Middle Ear ◽  
Disease Process ◽  
Optimal Conditions ◽  
Second Stage ◽  
Closed Technique ◽  
Middle Ear Cholesteatoma ◽  
Long Term Follow Up ◽  
Cholesteatoma Surgery

The closed technique is the treatment of choice for middle ear cholesteatoma in the opinion of the author. Several interventions may be required. At the onset, the purpose of the systematic second stage procedure was to verify the absence of any residual cholesteatoma. Experience has shown that the interest of this second intervention lies equally in the opportunity to observe the evolution of the otitis disease process, and the tubal status and in the possibility of restoring transmission under optimal conditions, thanks in particular to the utilization of thick silastic sheeting. This technique necessitates, however, a long-term follow-up. On occasion, a third intervention may be required. Despite the iterative nature of this surgery, it should be considered as a form of a logical progression offering the best chances of a successful anatomic and functional outcome for the patient.

Epicardial cryoablation as surgical treatment for atrial fibrillation: One year follow up in 84 patients

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
R Uhl ◽  
I Marcolino ◽  
E Zimmer ◽  
F Beyersdorf ◽  
E Eschenbruch
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
One Year
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