Diffuse idiopathic skeletal hyperostosis: an uncommon complication in head and neck surgery

<p>Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative disorder of unknown etiology that most often occurs in male patients over 50. Dysphagia is its main symptom, but they can also have dyspnea, otalgia, cough, sore throat, foreign body sensation in the pharynx, sleep apnea and glottic alterations. We present a case report and review the literature about this entity. We report a case of an oral squamous cell carcinoma that received a commando surgery and tracheostomy tube. Decanulations attempts were unsuccessful initially due to DISH. Conservative management was successful and complete rehabilitation performed, achieving decannulation 18 months after surgery. DISH can be a source of many different symptoms that may appear or be exacerbated after any surgery, and produce a postoperative complication. Conservative management is usually the best treatment, leaving surgical interventions for severe symptomatic patients. The knowledge of this entity and a high level of suspicion are very important for a proper diagnosis and management.</p>

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Primary Omental Torsion in an Old Woman: Imaging Techniques Can Prevent Unnecessary Surgical Interventions

Case Reports in Medicine ◽

10.1155/2011/541324 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Mohhamad-Hadi Saeed Modaghegh ◽

Reza Jafarzadeh

Keyword(s):

Computed Tomography ◽

Conservative Management ◽

Clinical Presentation ◽

Imaging Techniques ◽

Flank Pain ◽

Greater Omentum ◽

Surgical Interventions ◽

Omental Torsion ◽

Proper Diagnosis ◽

Primary Torsion

Torsion and/or infarction of the greater omentum are rare but well-recognized clinical situations which present as an acute abdomen. The etiology is unknown and speculative. In most cases, the pathology is right sided and clinical presentation consists of an acute or subacute flank pain with mild peritonism usually evoking appendicitis or cholecystitis. Nevertheless, knowledge concerning these two problems can help the surgeon in proper diagnosis and treatment. Since the first report on primary torsion by Eitel in 1899, a few hundred more have been reported and some collective reviews published to date. Recently, ultra sonography and computed tomography have proved to provide sufficiently typical, consistent, and well-recognizable features to avoid unnecessary surgery. In this study, we will present a case diagnosed as primary omental torsion based on computed tomography, which underwent successful conservative management.

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OPERATIONS FOR ANEURISM OF THE ABDOMINAL AORTIC DEPARTMENT - RESECTION WITH THE FOLLOWING PROSTHETICS AND ENDOPROSTHETICS: A COMPARATIVE ANALYSIS OF COMPLICATIONS

СИСТЕМНЫЙ АНАЛИЗ И УПРАВЛЕНИЕ В БИОМЕДИЦИНСКИХ СИСТЕМАХ ◽

10.36622/vstu.2020.19.2.007 ◽

2020 ◽

pp. 43-49

Author(s):

Андрей Анатольевич Иванов ◽

Александр Иванович Жданов ◽

Максим Сергеевич Шевелин ◽

Александр Сергеевич Брежнев

Keyword(s):

Comparative Analysis ◽

Postoperative Complications ◽

Statistical Significance ◽

Aortic Aneurysms ◽

Surgical Interventions ◽

Vein Thrombosis ◽

Scientific Hypothesis ◽

Abdominal Aortic ◽

Life Threatening ◽

High Level

В статье представлены данные оригинального исследования по улучшению хирургического лечения аневризм брюшного отдела аорты. С этой целью произведен сравнительный анализ двух альтернативных друг другу операций: 1) резекции аневризмы с последующим протезированием аорты; 2) эндопротезирования аорты. Сформулировано научное предположение о том, что замена «классических» операций резекции аневризмы на «альтернативные» операции эндопротезирования приведет к принципиальному снижению уровня послеоперационных осложнений. В независимых группах пациентов с использованием сравниваемых хирургических вмешательств произведена точная качественная и количественная оценка послеоперационных осложнений: нетромботических - кардиальных, пульмональных, ренальных и тромботических - тромбозов глубоких вен и тромбозов браншей протеза. После реализации исследования было установлено, что замена «классических» операций на «альтернативные» достоверно приводит к принципиальному снижению уровня наиболее жизнеопасных осложнений - кардиальных (острых форм ишемической болезни сердца, нарушений сердечного ритма), пульмональных (пневмоний, тромбоэмболии легочной артерии, респираторного дистресс-синдрома взрослых) и ренальных (острой почечной недостаточности). Некоторое исключение составили менее жизнеопасные тромботические осложнения. Полученные результаты имеют высокий уровень статистической значимости, что позволяет рекомендовать их к рассмотрению к использованию в практике сосудистой хирургии The article presents data from an original study to improve the surgical treatment of abdominal aortic aneurysms. For this purpose, a comparative analysis of two alternate operations was performed: 1) aneurysm resection followed by aortic prosthetics; 2) aortic endoprosthetics. The scientific hypothesis is formulated that the replacement of the «classical» operations of resection of the aneurysm with «alternative» operations of endoprosthetics will lead to a fundamental decrease in the level of postoperative complications. In independent groups of patients using the compared surgical interventions, an accurate qualitative and quantitative assessment of postoperative complications was made: non-thrombotic - cardiac, pulmonary, renal and thrombotic - deep vein thrombosis and prosthetic jaw thrombosis. After the study was completed, it was found that the fundamental replacement of «classical» operations with «alternative» reliably leads to a fundamental decrease in the level of the most life-threatening complications - cardiac (acute forms of coronary heart disease, cardiac arrhythmias), pulmonary (pneumonia, pulmonary thromboembolism, respiratory distress syndrome of adults) and renal (acute renal failure). Some exceptions were less life-threatening thrombotic complications. The results obtained have a high level of statistical significance, which allows us to recommend them for consideration in the practice of vascular surgery

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EP.FRI.12Meta-analysis of demographic and prognostic significance of right-sided versus left-sided acute diverticulitis

British Journal of Surgery ◽

10.1093/bjs/znab312.004 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Shahab Hajibandeh ◽

Shahin Hajibandeh ◽

Neil J Smart ◽

Andrew Maw

Keyword(s):

Hospital Stay ◽

Conservative Management ◽

Emergency Surgery ◽

Lower Risk ◽

Length Of Hospital Stay ◽

Colonic Diverticulitis ◽

Co Morbidity ◽

Male Patients ◽

The Right ◽

Acute Colonic Diverticulitis

Abstract Aims To compare the demographic and prognostic outcomes of right-sided versus left-sided acute colonic diverticulitis Methods We performed a systematic review in accordance with the PRISMA statement standards to identify all observational studies comparing demographic factors and outcomes of right-sided versus left-sided acute colonic diverticulitis. We used the ROBINS-I tool to assess the risk of bias of included studies. Random effects modelling was applied to calculate pooled outcome data. Results Analysis of 2933 patients from nine studies suggests that right-sided diverticulitis affects younger patients (MD:-14.16,P<0.00001) and more male patients (OR:1.33,P=0.02) compared with left-sided diverticulitis. Smoking (OR:2.23,P<0.0001), alcohol consumption (OR:1.85,P=0.002) and co-morbidity (OR:0.21,P<0.00001) were more common in patients with right-sided diverticulitis. The risk of complicated diverticulitis was lower in the right-sided group (OR:0.21,P=0.001). More patients in the right-sided diverticulitis group had modified Hinchey stage I disease (OR:10.21,P<0.0001) while more patients in the left-sided group had stage II (OR:0.19,P<0.00001), stage III (OR:0.08,P=0.009) or stage IV disease (OR:0.02,P<0.00001). Right-sided diverticulitis was associated with a lower risk of recurrence (OR:0.49,P=0.04), failure of conservative management (OR:0.14,P=0.0006), the need for emergency surgery (OR:0.13,<0.00001) and shorter length of hospital stay (MD:-1.70,P=0.02). Conclusions Right-sided acute colonic diverticulitis predominantly affects younger male patients compared with left-sided disease and is associated with favourable outcomes as indicated by the lower risk of complications, failure of conservative management, need for emergency surgery, recurrence, and shorter length of hospital stay. More studies are required to compare the postoperative outcomes in patients with right-sided and left-sided diverticulitis undergoing emergency surgery.

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A Small Bowel Perforation in a Goalkeeper: A Case Report and Return to Play Progression

Journal of Athletic Training ◽

10.4085/261-20 ◽

2021 ◽

Author(s):

Kenzie Johnston ◽

Tara A. Condon ◽

Mario Ciocca ◽

Alain Aguilar

Keyword(s):

Case Report ◽

Small Bowel ◽

Primary Repair ◽

Bowel Perforation ◽

Return To Sport ◽

Return To Play ◽

Small Bowel Perforation ◽

Unique Challenge ◽

Surgical Interventions ◽

High Level

Abstract Sports-related intra-abdominal injuries are rare and may be associated with significant morbidity if missed. We present the case of a 21-year-old male collegiate goalkeeper who suffered a small bowel perforation in practice after colliding with a teammate. This athlete underwent laparoscopic primary repair of his small bowel perforation, a relatively uncommon type of surgical intervention for this injury given that similar patients are typically treated via laparotomy. Due to rarity of small intestine injuries in sport, information regarding the success of surgical interventions and return to play (RTP) standards are lacking, let alone information on outcomes and return to sport following a laparoscopic repair. In this case report, we discuss the unique challenge of constructing a RTP protocol for this high-level athlete and propose a protocol for RTP following intra-abdominal injury treated laparoscopically.

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The Importance of Early Diagnosis of Pyoderma Gangrenosum: A Case After Plastic Surgery

WOUNDS A Compendium of Clinical Research and Practice ◽

10.25270/wnds/2021.e5860 ◽

2021 ◽

Vol 33 (7) ◽

pp. E58-E60

Author(s):

Gunel Guliyeva ◽

Ali Kilic

Keyword(s):

Hospital Stay ◽

Plastic Surgery ◽

Pyoderma Gangrenosum ◽

Reduction Mammoplasty ◽

Careful Examination ◽

Neutrophilic Dermatosis ◽

Unknown Etiology ◽

Surgical Trauma ◽

Surgical Interventions ◽

Low Incidence

Introduction. Pyoderma gangrenosum (PG) is a multifactorial neutrophilic dermatosis of unknown etiology. It can occur in isolation; in association with different inflammatory, autoimmune, or malignant diseases; or as part of various syndromes. Because of its low incidence and the difficulty in distinguishing it from other possible lesions, PG is usually misdiagnosed. As a result, patients may be subjected to unnecessary treatments and surgical interventions that exacerbate the development of PG, as pathergy phenomenon is observed with this skin disorder. Surgical trauma can also lead to the formation of PG with the same mechanism. The occurrence of PG lesions has been reported after plastic surgery as well. In most cases, however, the diagnosis is delayed, resulting in disfigurement, additional surgeries, and extended hospital stay. Case Report. In this article, a case of early detected bilateral PG after reduction mammoplasty in a patient with no personal or family history of autoimmune disorders is presented. Careful examination of the wound and analysis of the clinical picture resulted in the diagnosis of PG. Conclusions. The authors believe that the description of the diagnostic clues considered in this case will aid the plastic surgeon in prompt recognition and management of postoperative PG, with the aim of decreasing patient morbidity and the duration of hospital stay while preventing additional complications.

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Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1712169 ◽

2020 ◽

Vol 24 (03) ◽

pp. e258-e266 ◽

Cited By ~ 2

Author(s):

Luiz Paulo Kowalski ◽

Rui Imamura ◽

Gilberto de Castro Junior ◽

Gustavo Nader Marta ◽

Aline Lauda Freitas Chaves ◽

...

Keyword(s):

Head And Neck ◽

Online Survey ◽

Acute Infection ◽

Neck Region ◽

Neck Surgery ◽

Medical Specialties ◽

Head And Neck Region ◽

Professional Activities ◽

High Level ◽

The Impact

Abstract Introduction Coronavirus disease 2019 (COVID-19) is an acute infection caused by the new coronavirus (SARS-CoV-2) and it is highly transmissible, especially through respiratory droplets. To prepare the health system for the care of these patients also led to a restriction in the activity of several medical specialties. Physicians who work with patients affected by diseases of the head and neck region constitute one of the populations most vulnerable to COVID-19 and also most affected by the interruption of their professional activities. Objective The aim of the present study was to assess the impact of the COVID-19 pandemic on the practice of head and neck surgeons and otorhinolaryngologists in Brazil. Methods An anonymous online survey of voluntary participation was applied, containing 30 questions regarding demographic aspects, availability of personal protective equipment (PPE), and impact on the routine of head and neck surgeons and otorhinolaryngologists, as well as clinical oncologists and radiation oncologists who work with head and neck diseases. Results Seven hundred and twenty-nine answers were received in a period of 4 days, ∼ 40 days after the 1st confirmed case in Brazil. With professionals working in public and private services, there was a high level of concerns with the disease and its consequences, limited availability of PPE and a significant decrease in the volume of specialized medical care. Conclusion The study demonstrated a direct impact of the COVID-19 pandemic on the clinical practice of specialties related to the treatment of patients with diseases of the head and neck region already in the beginning of the illness management in Brazil.

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Metastasis of Colon Cancer to the Breast

Case Reports in Oncology ◽

10.1159/000455225 ◽

2017 ◽

Vol 10 (1) ◽

pp. 77-80 ◽

Cited By ~ 4

Author(s):

Swei H. Tsung

Keyword(s):

Colon Cancer ◽

Metastatic Disease ◽

Rare Event ◽

Clinical History ◽

Primary Cancer ◽

Breast Metastases ◽

Proper Diagnosis ◽

High Level

Breast metastases from extramammary neoplasms are extremely rare, and even more so is metastasis of colon cancer to the breast. Despite its rarity, metastatic disease to the breast is an important diagnostic issue because its treatment differs greatly from that of primary cancer. Proper diagnosis of this rare event requires an accurate clinical history, proper immunohistochemical workup, and a high level of suspicion.

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Tarsal Coalition of the Cuneiforms in an Elite Athlete: A Case Report

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00233 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0023

Author(s):

Alexander J. Johnson ◽

Eric Gokcen

Keyword(s):

Conservative Management ◽

Treatment Options ◽

Young Female ◽

Current Case ◽

Orthopedic Surgeons ◽

Clinical Literature ◽

Ct Evaluation ◽

Motion Mri ◽

Cadaver Studies ◽

High Level

Category: Midfoot/Forefoot, Sports Introduction/Purpose: Tarsal coalitions are a relatively common, often asymptomatic disorder with an incidence of 1-6% in clinical studies and 11-13% in cadaver studies. Calcaneonavicular, followed by talonavicular, are the most common forms of coalitions, but a variety of other coalitions have been described in radiographic, anatomic, and clinical literature. Despite the varied research that has focused on the topic in recent decades, there are no identified reports of cuneiform to cuneiform coalition in the literature. Methods: The authors present the unique case of medial and intermediate cuneiform coalition in a young female track athlete. A 19 year old female Division 1 hurdler presented with 1 year of atraumatic midfoot pain limiting her ability to compete. Despite evaluation by multiple orthopedic surgeons, the etiology of the pain was undetermined, and she had failed multiple conservative treatment options. Her exam revealed diffuse midfoot tenderness and increased midfoot pain with twisting motion. MRI and CT evaluation showed coalition between medial and intermediate cuneiforms with early degenerative changes. Ultrasound guided injection in this area resulted in relief of symptoms, confirming the diagnosis. The patient underwent coalition release and medial- intermediate cuneiform arthrodesis. Results: Postoperatively the patient underwent a period of nonweightbearing then progressed back to activity. CT scan confirmed solid arthrodesis and she was cleared to return to track competition. She successfully returned to competitive collegiate hurdling 11 months after surgery while noting only occasional discomfort in the foot. Conclusion: With no previous reports identified in the literature, cuneiform to cuneiform coalitions are a rare clinical entity. It is likely that the patient in the current case experienced symptoms related to this pathology because of her high level athletic participation. After failing conservative management, the patient experienced a good outcome after coalition release and arthrodesis. Although it is likely that patients with similar pathology who fail conservative management may expect similarly positive outcomes, review of future cases will help further define the optimal treatment for this condition.

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Desarda Versus Lichtenstein Repair for Primary Inguinal Hernia in Men: Results of A Randomized Control Trial

Faridpur Medical College Journal ◽

10.3329/fmcj.v14i1.46161 ◽

2020 ◽

Vol 14 (1) ◽

pp. 20-26

Author(s):

ASM Tanjilur Rahman ◽

Swapan Kumar Biswas ◽

Ratan Kumar Saha ◽

ASM Zahidur Rahman ◽

Tanvir Ahmed ◽

...

Keyword(s):

Inguinal Hernia ◽

Low Cost ◽

Cost Effective ◽

Lichtenstein Repair ◽

Primary Inguinal Hernia ◽

Body Sensation ◽

Mesh Hernia Repair ◽

Male Patients ◽

The One

Inguinal hernia is a very common surgical problem for which mesh based technique particularly Lichtenstein repair is considered as standard. However, it is not free from some major and bothersome complications. Desarda technique of non-mesh hernia repair invented by the Indian surgeon is claimed as low cost tension free procedure with promising results. The objective of the study is to evaluate the feasibility of Desarda procedure in country like Bangladesh as a treatment of primary inguinal hernia in men by comparing with Lichtenstein repair in terms of various parameters. One hundred and sixty male patients between ages of 18-70 years with uncomplicated primary inguinal hernia were initially randomized to perform the one of the two procedures in every alternate patient. Outcome were measured and analyzed. A total of 100 patients were finally studied with a follow up of 2 years. Operative time and immediate postoperative pain were significantly less in Desarda arm. Cost and foreign body sensation were also in favour of Desarda group. There was no recurrence in either group. Desarda repair is easy to perform and takes less time. It is cost effective with a comparable clinical outcome to standard Lichtenstein repair at least in short term. Faridpur Med. Coll. J. Jan 2019;14(1): 20-26

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Anterior Cervical Osteophyte Resection for Treatment of Dysphagia

Global Spine Journal ◽

10.1177/2192568220912706 ◽

2020 ◽

pp. 219256822091270

Author(s):

Joshua M. Kolz ◽

Mohammed A. Alvi ◽

Atiq R. Bhatti ◽

Marko N. Tomov ◽

Mohamad Bydon ◽

...

Keyword(s):

Retrospective Cohort ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Neck Surgery ◽

High Complication Rate ◽

Disc Space ◽

Swallowing Function ◽

Cervical Osteophytes ◽

Cervical Disease ◽

The Mean

Study Design: This was a retrospective cohort study. Objectives: When anterior cervical osteophytes become large enough, they may cause dysphagia. There is a paucity of work examining outcomes and complications of anterior cervical osteophyte resection for dysphagia. Methods: Retrospective review identified 19 patients who underwent anterior cervical osteophyte resection for a diagnosis of dysphagia. The mean age was 71 years and follow-up, 4.7 years. The most common level operated on was C3-C4 (13, 69%). Results: Following anterior cervical osteophyte resection, 79% of patients had improvement in dysphagia. Five patients underwent cervical fusion; there were no episodes of delayed or iatrogenic instability requiring fusion. Fusion patients were younger (64 vs 71 years, P = .05) and had longer operative times (315 vs 121 minutes, P = .01). Age of 75 years or less trended toward improvement in dysphagia ( P = .09; OR = 18.8; 95% CI 0.7-478.0), whereas severe dysphagia trended toward increased complications ( P = .07; OR = 11.3; 95% CI = 0.8-158.5). Body mass index, use of an exposure surgeon, diffuse idiopathic skeletal hyperostosis diagnosis, surgery at 3 or more levels, prior neck surgery, and fusion were not predictive of improvement or complication. Conclusions: Anterior cervical osteophyte resection improves swallowing function in the majority of patients with symptomatic osteophytes. Spinal fusion can be added to address stenosis and other underlying cervical disease and help prevent osteophyte recurrence, whereas intraoperative navigation can be used to ensure complete osteophyte resection without breaching the cortex or entering the disc space. Because of the relatively high complication rate, patients should undergo thorough multidisciplinary workup with swallow evaluation to confirm that anterior cervical osteophytes are the primary cause of dysphagia prior to surgery.

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