scholarly journals Intratympanic corticosteroid perfusion in the therapy of Meniere’s disease

2014 ◽  
Vol 142 (5-6) ◽  
pp. 291-295 ◽  
Author(s):  
Snezana Sankovic-Babic ◽  
Rade Kosanovic ◽  
Zoran Ivankovic ◽  
Snezana Babac ◽  
Milica Tatovic
Keyword(s):  
Minimally Invasive ◽  
Action Potentials ◽  
Therapeutic Option ◽  
Experimental Studies ◽  
Hearing Threshold ◽  
Minimally Invasive Surgical ◽  
Hearing Function ◽  
One Year

Introduction. Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere?s disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. Objective. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere?s disease who are resistant to conservative treatment. Methods. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere?s disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. Results. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Conclusion. Intratympanic perfusion of dexamethasone in patients with Meniere?s disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere?s disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic ulcer, etc.) have an additional therapeutic option by dexamethasone intratympanic perfusion.

Proper Surgical Treatment of Small and Medium Size Umbilical Hernias. A Single Surgeon Experience

2020 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Etele Élthes ◽  
Daniela Sala ◽  
Radu Mircea Neagoe ◽  
János Székely ◽  
Márton Dénes
Keyword(s):  
Minimally Invasive ◽  
Therapeutic Option ◽  
Minimal Invasive ◽  
Medium Size ◽  
Open Approach ◽  
Invasive Treatment ◽  
Minimally Invasive Surgical ◽  
Surgeon Experience ◽  
Group B

AbstractIntroduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results.Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias.Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed.Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group.Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.

Open Treatment of Osteochondral Lesions of the Talus With Bone Grafting and Particulated Juvenile Cartilage Allografting

2021 ◽  
pp. 193864002110097
Author(s):  
Suhas P. Dasari ◽  
Thomas M. Langer ◽  
Derek Parshall ◽  
Brian Law
Keyword(s):  
Therapeutic Option ◽  
Symptomatic Improvement ◽  
Pain Scale ◽  
Osteochondral Lesions ◽  
Outcome Scores ◽  
Scale Scores ◽  
Open Treatment ◽  
Bone Autograft

Background: Large cystic osteochondral lesions of the talus (OLT) are challenging pathological conditions to treat, but particulated juvenile cartilage allografts (PJCAs) supplemented with bone grafts are a promising therapeutic option. The purpose of this project was to further elucidate the role of PJCA with concomitant bone autografts for treating large cystic OLTs with extensive subchondral bone involvement (greater than 150 mm2 in area and/or deeper than 5 mm). Methods: We identified 6 patients with a mean OLT area of 307.2 ± 252.4 mm2 and a mean lesion depth of 10.85 ± 6.10 mm who underwent DeNovo PJCA with bone autografting between 2013 and 2017. Postoperative outcomes were assessed with radiographs, Foot and Ankle Outcome Scores (FAOS), and visual pain scale scores. Results: At final follow-up (27.0 ± 12.59 weeks), all patients had symptomatic improvement and incorporation of the graft on radiographs. At an average of 62 ± 20.88 months postoperatively, no patients required a revision surgery. All patients contacted by phone in 2018 and 2020 reported they would do the procedure again in retrospect and reported an improvement in their symptoms relative to their preoperative state, especially with pain and in the FAOS activities of daily living subsection (91.93 ± 9.04 in 2018, 74.63 ± 26.86 in 2020). Conclusion: PJCA with concomitant bone autograft is a viable treatment option for patients with large cystic OLTs. Levels of Evidence: Level IV

Individualized Behavioural Treatment of Severe Stuttering

1991 ◽  
Vol 19 (4) ◽  
pp. 347-357 ◽  
Author(s):  
Willi Ecker ◽  
Victor Meyer
Keyword(s):  
Oral Reading ◽  
Reading Improvement ◽  
Behavioural Treatment ◽  
Communication Situations ◽  
Cognitive Techniques ◽  
One Year

This case study illustrates the reduction of severe stuttering by an individually tailored treatment programme. Interventions are derived from a tripartite analysis (Lang, 1971) and include EMG biofeedback, regulated breathing, exposure in vivo to stressful communication situations and cognitive techniques to reduce relapse risk. The role of dysfunctional response system interactions in stuttering is emphasized. Treatment resulted in a marked reduction of stuttering and associated facial contortions during videotaped conversations with strangers and oral reading. Improvement was maintained at one-year follow-up.

scholarly journals Role of methyleprednisolone succinate in the management of acute spinal cord injury

1970 ◽  
Vol 9 (3) ◽  
pp. 168-172
Author(s):  
NK Karn ◽  
BP Shrestha ◽  
GP Khanal ◽  
R Rijal ◽  
P Chaudhary ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Status ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
And Gender ◽  
One Year

Objective: To see the role of methyleprednisolone succinate in the management of acute spinal cord injury. Methods: A randomized control trial was done including the patients with acute spinal cord injury. They were divided into age and gender matched two groups. Patients with presence of active infection, associated open fracture, those on long term steroid and those who did not give consent to participate in the trial were excluded. One group received methyleprednisolone succinate within 8 hours of injury and another group did not receive the drug. Both the groups were managed nonoperatively. The neurological status of the patients was assessed at presentation, once spinal shock was over, at 6th week and 6th month and after one year according to ASIA scoring. Frankel grading was also assessed in every follow up. Conclusion: Methylprednisolone succinct prevents secondary cord injury to a great extent and hence its administration within 8 hours of injury results in a better functional (motor and sensory) outcome. Keywords: acute spinal cord injury; methyleprednisolone succinate DOI: http://dx.doi.org/10.3126/hren.v9i3.5585   HR 2011; 9(3): 168-172

scholarly journals Results of a novel surgical technique for iridodialysis repair using segments

2021 ◽  
Author(s):  
Ugur Unsal ◽  
Huri Sabur ◽  
Mehmet Soyler
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Study Data ◽  
Invasive Technique ◽  
Minimally Invasive Surgical ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
Surgical Manipulation

Abstract Purpose: To describe a novel surgical technique for iridodialysis repair using iris retractor segments and report its clinical results.Methods: 53 eyes of 53 patients who underwent surgery for iridodialysis repair were enrolled in this retrospective study. Data recorded from patient files consisted of age, sex, history of trauma, surgical indications and type of surgery, preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and follow-up time. The novel, minimally invasive surgical technique was explicitly described in detail.Results: Mean follow-up time was 34.4 (range 12-84) months. The subjects were 29 (54.7%) men and 26 (45.3%) women, and the mean age was 56.6±14.0 years. Iridodialysis repair performed using one segment in 37 (69.8%) eyes, two segments in 15 (28.3%) eyes, and three segments in 1 (1.9%) eye. Pupilloplasty was performed in 17 eyes due to wide pupil diameter. The iridodialysis repair was combined with lens removal in 48 eyes, and anterior vitrectomy was performed in 10 eyes. CDVA significantly improved after surgery (p<0.001). Post-traumatic IOP rise was the most common complication, and six patients needed medical therapy for glaucoma control.Conclusion: Iridodialysis repair using iris retractor segment is a minimally invasive technique and found to be safe and effective, providing less surgical manipulation and surgical time than other techniques.

scholarly journals A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy

2016 ◽  
Vol 40 (6) ◽  
pp. E7 ◽  
Author(s):  
Syed F. Abbas ◽  
Morgan P. Spurgas ◽  
Benjamin S. Szewczyk ◽  
Benjamin Yim ◽  
Ashar Ata ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Neck Disability Index ◽  
Case Series ◽  
Patient Characteristics ◽  
Short Term ◽  
Instrumented Fusion ◽  
Minimally Invasive Surgical ◽  
Neck Disability

OBJECTIVE Minimally invasive posterior cervical decompression (miPCD) has been described in several case series with promising preliminary results. The object of the current study was to compare the clinical outcomes between patients undergoing miPCD with anterior cervical discectomy and instrumented fusion (ACDFi). METHODS A retrospective study of 74 patients undergoing surgery (45 using miPCD and 29 using ACDFi) for myelopathy was performed. Outcomes were categorized into short-term, intermediate, and long-term follow-up, corresponding to averages of 1.7, 7.7, and 30.9 months, respectively. Mean scores for the Neck Disability Index (NDI), neck visual analog scale (VAS) score, SF-12 Physical Component Summary (PCS), and SF-12 Mental Component Summary (MCS) were compared for each follow-up period. The percentage of patients meeting substantial clinical benefit (SCB) was also compared for each outcome measure. RESULTS Baseline patient characteristics were well-matched, with the exception that patients undergoing miPCD were older (mean age 57.6 ± 10.0 years [miPCD] vs 51.1 ± 9.2 years [ACDFi]; p = 0.006) and underwent surgery at more levels (mean 2.8 ± 0.9 levels [miPCD] vs 1.5 ± 0.7 levels [ACDFi]; p < 0.0001) while the ACDFi patients reported higher preoperative neck VAS scores (mean 3.8 ± 3.0 [miPCD] vs 5.4 ± 2.6 [ACDFi]; p = 0.047). The mean PCS, NDI, neck VAS, and MCS scores were not significantly different with the exception of the MCS score at the short-term follow-up period (mean 46.8 ± 10.6 [miPCD] vs 41.3 ± 10.7 [ACDFi]; p = 0.033). The percentage of patients reporting SCB based on thresholds derived for PCS, NDI, neck VAS, and MCS scores were not significantly different, with the exception of the PCS score at the intermediate follow-up period (52% [miPCD] vs 80% [ACDFi]; p = 0.011). CONCLUSIONS The current report suggests that the optimal surgical strategy in patients requiring dorsal surgery may be enhanced by the adoption of a minimally invasive surgical approach that appears to result in similar clinical outcomes when compared with a well-accepted strategy of ventral decompression and instrumented fusion. The current results suggest that future comparative effectiveness studies are warranted as the miPCD technique avoids instrumented fusion.

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