scholarly journals Dysphagia in Patients with Neck Dissections

2019 ◽  
Vol 7 (08) ◽  
Author(s):  
Zornitsa Mihaylova
Keyword(s):  
Longitudinal Study ◽  
Neck Dissection ◽  
Postoperative Period ◽  
Speech Disorders ◽  
Common Complication ◽  
Swallowing Function ◽  
Anatomical Structures ◽  
Significant Difference ◽  
Swallow Function ◽  
Cervical Area

A common complication in patients with malignancies in the maxillofacial and cervical area is the impaired swallowing, due to the progress of the neoplasm or as a result of the treatment applied. Operative methods for the management of malignancies in the maxillofacial and cervical areas may damage anatomical structures, therefore causing swallowing disorders. The purpose of the present study is to determine the degree of involvement of the swallow function depending on the volume of surgery - neck dissection. Methods: SSQ (Sydney Swallowing Questionnaire) tool was used to assess the presence of dysphagia in operated patients, as well as an impaired swallowing function. The results obtained were analyzed by SPSS Vers23.0.         Results. Prospectively longitudinal study included 68 patients (25 women and 43 men) at mean age of 61.18 years (SD - 13.66). The reliability of the SSQ tool is assessed via Cronbach's coefficient alpha α = 0.871, and the validity of the sample is calculated using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO coefficient) - 0.857. In the postoperative period, no significant difference in dysphagia was found in terms of the volume of surgery - neck dissection.             Conclusion. The type and the volume of neck dissection has no effect on the postoperative speech disorders and swallowing.

Complications after Functional Neck Dissection in Head and Neck Cancer Patients: An Observational, Retrospective, Single-Centre Study

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Carlos M. Chiesa-Estomba ◽  
Maria Soriano-Reixach ◽  
Izaskun Thomas-Arrizabalaga ◽  
Jon A. Sistiaga-Suarez ◽  
Jose A. González-García ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Postoperative Period ◽  
Surgical Complications ◽  
Statistical Correlation ◽  
University Hospital ◽  
Common Complication ◽  
Neck Malignancy ◽  
Single Centre Study ◽  
Functional Neck Dissection

<b><i>Introduction:</i></b> Functional neck dissection (FND) represents a surgical procedure usually associated with less morbidity. <b><i>Methods:</i></b> An observational, retrospective, analysis of patients diagnosed with any type of head and neck malignancy was designed to summarize and report the incidence of postoperative complications in patients undergoing FND including just those levels described for selective neck dissections in a tertiary university hospital between June 2016 and June 2019. <b><i>Results:</i></b> 131 patients met the inclusion criteria. The total number of sides studied was 200. 40.5% of the patients suffer a complication in the postoperative period, being the spinal accessory nerve (SAN) injury the most common complication (10%). We did not find any statistical ­correlation between the previous organ-preservation treatments and surgical complications (<i>p</i> = 0.207). An advanced T stage (<i>p</i> = 0.009) and the need of bilateral FND (<i>p</i> = 0.034) were significantly correlated with a higher risk of surgical complications. <b><i>Conclusion:</i></b> FND represents a useful technique. In this study, 40.5% of the patients suffer a complication in the postoperative period, being the SAN injury the most common complication. However, these data contribute to increasing our knowledge about surgical complications related to FND.

scholarly journals Musculoskeletal Disorders of the Cervical Spine Following Neck Dissections Due to Malignancies of the Head And Neck

2019 ◽  
Vol 7 (09) ◽  
Author(s):  
Zornitsa Mihaylova
Keyword(s):  
Cervical Spine ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Musculoskeletal Disorders ◽  
Motor Function ◽  
Musculoskeletal System ◽  
Lateral Flexion ◽  
Anatomical Structures ◽  
Surgical Interventions ◽  
Significant Difference

Neck dissections are surgical interventions aiming the removal of lymph nodes from specific areas of the neck, together with non-lymphatic structures falling within the scope of the operation – m. sternocleidomasstoideus (MSCM), v. jugularis interna (VJI), n. accessorius (N.XI). Due to the involvement of important anatomical structures in the neck dissections, postoperative outcoomes and complications associated with impaired function of the musculoskeletal system of the neck arise. The purpose of the present study is to determine the degree of cervical spine movements depending on the volume of surgical neck dissection.             Methods. The goniometry method was used to evaluate the motor function of the operated patients. The results obtained were analyzed via SPSS Vers23.0. Results. A statistically significant difference was observed postoperatively at the 3rd month in all directions of movement studied in the three groups of operative interventions (neck dissections): flexion – F(2,65)=643.566, p<0.001; extension – F(2,65)=445.045, p<0.001; lateral flexion – F(2,65)=314.077, p<0.001; rotation – F(2,65)=121.980, p<0.001.             Conclusion. Assessment of the cervical spine shows that all directions of movement are affected, most significantly affecting lateral flexion in all groups of operated patients with neck dissection.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

2018 ◽  
pp. 26-31
Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Traditional Therapy ◽  
Significant Difference ◽  
Water Salt ◽  
Experimental Group

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.

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.

scholarly journals Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study

Materials ◽  
2021 ◽  
Vol 14 (10) ◽  
pp. 2661
Author(s):  
Kiche Shim ◽  
Young-Eun Jang ◽  
Yemi Kim
Keyword(s):  
Postoperative Pain ◽  
Postoperative Period ◽  
Root Canal ◽  
Continuous Wave ◽  
Root Canal Treatment ◽  
Root Canals ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Ah Plus ◽  
Group 2

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.

Effect of Silver Nitrate Application on the Success of Endoscopic Dacryocystorhinostomy

2021 ◽  
pp. 194589242110427
Author(s):  
Yaser S. Çetin ◽  
Ramazan Akın ◽  
Ufuk Düzenli ◽  
Mahfuz Turan ◽  
Nazım Bozan
Keyword(s):  
Silver Nitrate ◽  
Success Rate ◽  
Postoperative Period ◽  
Revision Surgery ◽  
Granuloma Formation ◽  
Stent Insertion ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Silicone Stent

Objectives To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature. Methods The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates. Results Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III ( P = .4). The most common reason for revision surgery was stenosis of the neo-ostium ( n = 8), followed by granulation tissue formation ( n = 5) and synechia formation ( n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation ( P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates ( P = .79 and P = .76, respectively). Conclusion The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.

Modified Breast Band Improving the Postoperative Breast Augmentation and Reconstructive Experience

2021 ◽  
pp. 074880682110327
Author(s):  
Arian Mowlavi ◽  
Bryce Bash ◽  
Shea Skenderian ◽  
Zachary Sin
Keyword(s):  
Postoperative Period ◽  
Breast Augmentation ◽  
Breast Implant ◽  
Early Postoperative Period ◽  
Common Complication ◽  
Reconstructive Procedures ◽  
Implant Position ◽  
Time Period ◽  
To Receive

Superior displacement of implants is a common complication in the early postoperative period following breast augmentation surgery. Postoperative breast bands are used during the first 4 weeks to optimize breast implant position following breast augmentation and reconstructive procedures. Although currently available breast bands are effective in maintaining implants in an inferior position, they have been observed to irritate the armpit region. We hypothesized that a modified breast band geometry with cut outs to accommodate the armpit region would provide equal maintenance of desired implant position while providing improved postoperative comfort. Forty patients who underwent breast augmentation and/or reconstruction were randomly assigned to receive either the traditional breast band or the modified cut out designed breast band following surgery for 4 weeks. Patients rated their breast bands on a 1 to 10 scale regarding (1) comfort, (2) appearance, and (3) overall satisfaction at their routine postoperative visits at 1, 2, and 4 weeks following surgery. The modified breast band scored higher for all factors at 1, 2, and 4 weeks following surgery. The traditional band demonstrated decreasing scores for comfort and overall satisfaction when compared at 4 weeks versus 1 week. There was no change in the modified breast band scores for comfort, appearance, nor overall satisfaction over the same time period. This study of 40 patients found that the modified band provides equally effective maintenance of implants in a desired position without compromising comfort and appearance. Patients who used the modified band had a better experience with the band comfort, appearance, and overall satisfaction in comparison to the traditional band. The higher ratings for the cut out band for comfort, appearance, and overall satisfaction were consistent from week 1 to 4. In contrast, the traditional band not only scored lower in comfort, appearance, and overall satisfaction compared to the modified band but also demonstrated significant decrease in the patients’ ratings for comfort and overall satisfaction for the traditional band from week 1 to 4. This study supports the conclusion that a modified cut out breast band design provides an equally effective maintenance of implants in a desired position without compromising comfort, appearance, and overall satisfaction when compared to the traditional band.

Evaluation of Postoperative Pain after Sinonasal Surgery

2005 ◽  
Vol 19 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Sarah K. Wise ◽  
Justin C. Wise ◽  
John M. DelGaudio
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Postoperative Period ◽  
Repeated Measures ◽  
Medication Use ◽  
Pain Rating ◽  
Pain Location ◽  
Significant Difference ◽  
Chi Square Analysis ◽  
Analgesic Use

Background Pain after sinonasal surgery concerns both patients and surgeons. Factors affecting sinonasal postoperative pain have not been examined extensively. Methods Using a prospective survey design, sinonasal surgery patients evaluated postoperative pain (on a scale of 0–10), pain location, and medication use. Results One hundred twenty-seven patients consented to participate. One hundred fifteen patients returned surveys, with 100 patients appropriate for analysis over the 6-day postoperative period. Pain score and medication use were evaluated with respect to sex, primary/revision case, nasal packing, and other factors. Repeated measures analysis of variance and chi-square analysis were conducted (p < 0.05). Pain ratings and analgesic use declined significantly over the postoperative period (p < 0.05). Mean pain score on postoperative day (POD) 1 was 3.61 and on POD 6 was 1.72. Mean medication use was 1.37 tablets on POD 1 and 0.55 tablets on POD 6. Additionally, a significant interaction existed, such that narcotic medication use declined from 1.91 tablets on POD 1 to 0.52 tablets on POD 6, whereas nonnarcotic medication use remained steady (p < 0.05). Periorbital pain was most frequent (46.3%), with unilateral facial pain reported least (4.1%). A significant difference existed for distribution of pain location (p < 0.05). Finally, the difference in pain rating between primary and revision procedure for women (0.65) was less than for men (1.12); this interaction was significant (p < 0.05). Conclusion Multiple patient and operative factors affect pain rating and medication use after sinonasal surgery. Generally, pain level should be low with little analgesic use postoperatively.

Risk of Damaging Anatomical Structures During Minimally Invasive Hallux Valgus Correction (Bösch Technique): An Anatomical Study

2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
Author(s):  
Martin Kaipel ◽  
Lukas Reissig ◽  
Lukas Albrecht ◽  
Stefan Quadlbauer ◽  
Joachim Klikovics ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Complication Rate ◽  
Metatarsal Osteotomy ◽  
Anatomical Structures ◽  
Intensive Training ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.

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