Surgical treatment of single-suture craniosynostosis: an argument for quantitative methods to evaluate cosmetic outcomes

2010 ◽  
Vol 6 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Todd C. Hankinson ◽  
Elizabeth J. Fontana ◽  
Richard C. E. Anderson ◽  
Neil A. Feldstein
Keyword(s):  
Surgical Treatment ◽  
Intracranial Hypertension ◽  
Quantitative Methods ◽  
Surgical Techniques ◽  
Neurocognitive Deficits ◽  
External Compression ◽  
Operative Outcomes ◽  
History Of ◽  
Considerable Work ◽  
Single Suture

The traditional reasons for surgical intervention in children with single-suture craniosynostosis (SSC) are cosmetic improvement and the avoidance/treatment of intracranial hypertension, which has been thought to contribute to neurocognitive deficits. Despite considerable work on the topic, the exact prevalence of intracranial hypertension in the population of patients with SSC is unknown, although it appears to be present in only a minority. Additionally, recent neuropsychological and anatomical literature suggests that the subtle neurocognitive deficits identified in children with a history of SSC may not result from external compression. They may instead reflect an underlying developmental condition that includes disordered primary CNS development and early suture fusion. This implies that current surgical techniques are unlikely to prevent neurocognitive deficits in patients with SSC. As such, the most common indication for surgical treatment in SSC is cosmetic, and most patients benefit from considerable subjective cosmetic normalization following surgery. Pediatric craniofacial surgeons have not, however, agreed upon objective means to assess postoperative cranial morphological improvement. We should therefore endeavor to agree upon objective craniometric tools for the assessment of operative outcomes, allowing us to accurately compare the various surgical techniques that are currently available.

The article contains the analysis of the literature devoted to the correction of hypospadias in children. Parallels are drawn between classical works and modern trends in the treatment of this malformation. New surgical techniques (with reference to the history of their appearance) and developments are described. There is a discussion about the use of single and staged surgical interventions in the proximal hypospadias, the analysis of literary data about the complications, results of operations. New classification parameters of hypospadias, methods of assessing the severity of the defect before surgery, functional and cosmetic results after surgery are described. Attention is paid to such direction as standardization of approaches to surgical treatment of hypospadias, unification of methods of urethroplasty and correction of penile curvature. The data of clinical studies on the use of various operational techniques are presented.

2019 ◽  
pp. 82-86
Author(s):  
A. Z. Tibilov ◽  
N. B. Kireeva
Keyword(s):  
Surgical Treatment ◽  
Clinical Studies ◽  
Surgical Techniques ◽  
Penile Curvature ◽  
New Classification ◽  
Surgical Interventions ◽  
Cosmetic Results ◽  
Proximal Hypospadias ◽  
History Of

The article contains the analysis of the literature devoted to the correction of hypospadias in children. Parallels are drawn between classical works and modern trends in the treatment of this malformation. New surgical techniques (with reference to the history of their appearance) and developments are described. There is a discussion about the use of single and staged surgical interventions in the proximal hypospadias, the analysis of literary data about the complications, results of operations. New classification parameters of hypospadias, methods of assessing the severity of the defect before surgery, functional and cosmetic results after surgery are described. Attention is paid to such direction as standardization of approaches to surgical treatment of hypospadias, unification of methods of urethroplasty and correction of penile curvature. The data of clinical studies on the use of various operational techniques are presented.

scholarly journals Bouveret Syndrome—The Rarest Variant of Gallstone Ileus: A Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Vasileios K. Mavroeidis ◽  
Dimitrios I. Matthioudakis ◽  
Nikolaos K. Economou ◽  
Ioannis D. Karanikas
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Gallstone Ileus ◽  
Surgical Techniques ◽  
Outlet Obstruction ◽  
Cholecystoduodenal Fistula ◽  
Endoscopic Techniques ◽  
History Of ◽  
Bouveret Syndrome ◽  
The Right

We present a case report of a patient with Bouveret syndrome with interesting radiological findings and successful surgical treatment after failure of the endoscopic techniques. The report is followed by a review of the literature regarding the diagnostic means and proper treatment of this rare entity. Bouveret syndrome refers to the condition of gastric outlet obstruction caused by the impaction of a large gallstone into the duodenum after passage through a cholecystoduodenal fistula. Many endoscopic and surgical techniques have been described in the management of this syndrome. This is a case of a 78-year-old patient with severe medical history who presented in bad general condition with an 8-day history of nausea, multiple bilious vomiting episodes, anorexia, discomfort in the right hypochondrium and epigastrium, and fever up to 38,5°C. The diagnosis of Bouveret syndrome was set after performing the proper imaging studies. An initial endoscopic effort to resolve the obstruction was performed without success. Surgical treatment managed to extract the impacted gallstone through an enterotomy after removal into the first part of the jejunum.

scholarly journals Surgical Treatment of Ebstein's Anomaly

2017 ◽  
Vol 65 (08) ◽  
pp. 639-648 ◽  
Author(s):  
Rüdiger Lange ◽  
Melchior Burri
Keyword(s):  
Surgical Treatment ◽  
Right Ventricular ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Right Ventricular Failure ◽  
Ebstein’S Anomaly ◽  
Ventricular Failure ◽  
Ebstein's Anomaly ◽  
History Of ◽  
Surgical Options

AbstractSurgical repair of the tricuspid valve is a milestone in the medical history of patients with Ebstein's anomaly. The timely alleviation of the insufficiency has an important impact on the prognosis. In this review, we describe features of the disease relevant to surgical correction and the evolution of surgical techniques over six decades. We compare the results of different repair and replacement techniques. Additionally, we discuss concomitant antiarrhythmic surgery and bailout strategies for postoperative right ventricular failure. Finally, we review the surgical options in symptomatic neonates with Ebstein's disease.

scholarly journals Operative Outcomes for Cervical Myelopathy and Radiculopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
J. G. Galbraith ◽  
J. S. Butler ◽  
A. M. Dolan ◽  
J. M. O'Byrne
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Intractable Pain ◽  
Spinal Stability ◽  
Nerve Roots ◽  
Operative Outcomes ◽  
Anterior Posterior

Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

scholarly journals Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence

2014 ◽  
Vol 61 (1) ◽  
pp. 85-90
Author(s):  
Jovan Hadzi-Djokic ◽  
Uros Babic ◽  
Aleksandar Argirovic ◽  
Miodrag Acimovic ◽  
Milan Radovanovic ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Stress Urinary Incontinence ◽  
Pathological Condition ◽  
Surgical Techniques ◽  
Diagnostic Methods ◽  
Review Of The Literature ◽  
Scientific Papers ◽  
History Of ◽  
Urine Leakage

Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also per- formed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.

Computers in Geology - 25 Years of Progress

1994 ◽  
Keyword(s):  
Computer Modeling ◽  
Quantitative Methods ◽  
State Of The Art ◽  
International Association ◽  
Mathematical Geology ◽  
25Th Anniversary ◽  
The Earth ◽  
Wide Range ◽  
History Of ◽  
Mapping Techniques

This volume vividly demonstrates the importance and increasing breadth of quantitative methods in the earth sciences. With contributions from an international cast of leading practitioners, chapters cover a wide range of state-of-the-art methods and applications, including computer modeling and mapping techniques. Many chapters also contain reviews and extensive bibliographies which serve to make this an invaluable introduction to the entire field. In addition to its detailed presentations, the book includes chapters on the history of geomathematics and on R.G.V. Eigen, the "father" of mathematical geology. Written to commemorate the 25th anniversary of the International Association for Mathematical Geology, the book will be sought after by both practitioners and researchers in all branches of geology.

scholarly journals Long-Term Clinical Outcomes of Osteochondritis Dissecans Lesions of the Elbow Treated with Arthroscopy

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0020
Author(s):  
Michael Ryan ◽  
Benton Emblom ◽  
E. Lyle Cain ◽  
Jeffrey Dugas ◽  
Marcus Rothermich
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Failure Rate ◽  
Osteochondritis Dissecans ◽  
Surgical Techniques ◽  
The Other ◽  
Return To Play ◽  
Exclusion Criteria

Objectives: While numerous studies exist evaluating the short-term clinical outcomes for patients who underwent arthroscopy for osteochondritis dissecans (OCD) of the capitellum, literature on long-term clinical outcomes for a relatively high number of this subset of patients from a single institution is limited. We performed a retrospective analysis on all patients treated surgically for OCD of the capitellum at our institution from January 2001 to August 2018. Our hypothesis was that clinical outcomes for patients treated arthroscopically for OCD of the capitellum would be favorable, with improved subjective pain scores and acceptable return to play for these patients. Methods: Inclusion criteria for this study included the diagnosis and surgical treatment of OCD of the capitellum treated arthroscopically with greater than 2-year follow-up. Exclusion criteria included any surgical treatment on the ipsilateral elbow prior to the first elbow arthroscopy for OCD at our institution, a missing operative report, and/or any portions of the arthroscopic procedure that were done open. Follow-up was achieved over the phone by a single author using three questionnaires: American Shoulder and Elbow Surgeons – Elbow (ASES-E), Andrews/Carson KJOC, and our institution-specific return-to-play questionnaire. Results: After the inclusion and exclusion criteria were applied to our surgical database, our institution identified 101 patients eligible for this study. Of these patients, 3 were then excluded for incomplete operative reports, leaving 98 patients. Of those 98 patients, 81 were successfully contacted over the phone for an 82.7% follow-up rate. The average age for this group at arthroscopy was 15.2 years old and average post-operative time at follow-up was 8.2 years. Of the 81 patients, 74 had abrasion chondroplasty of the capitellar OCD lesion (91.4%) while the other 7 had minor debridement (8.6%). Of the 74 abrasion chondroplasties, 29 of those had microfracture, (39.2% of that subgroup and 35.8% of the entire inclusion group). Of the microfracture group, 4 also had an intraarticular, iliac crest, mesenchymal stem-cell injection into the elbow (13.7% of capitellar microfractures, 5.4% of abrasion chondroplasties, and 4.9% of the inclusion group overall). Additional arthroscopic procedures included osteophyte debridement, minor synovectomies, capsular releases, manipulation under anesthesia, and plica excisions. Nine patients had subsequent revision arthroscopy (11.1% failure rate, 5 of which were at our institution and 4 of which were elsewhere). There were also 3 patients within the inclusion group that had ulnar collateral ligament reconstruction/repair (3.7%, 1 of which was done at our institution and the other 2 elsewhere). Lastly, 3 patients had shoulder operations on the ipsilateral extremity (3.7%, 1 operation done at our institution and the other 2 elsewhere). To control for confounding variables, scores for the questionnaires were assessed only for patients with no other surgeries on the operative arm following arthroscopy (66 patients). This group had an adjusted average follow-up of 7.9 years. For the ASES-E questionnaire, the difference between the average of the ASES-E function scores for the right and the left was 0.87 out of a maximum of 36. ASES-E pain was an average of 2.37 out of a max pain scale of 50 and surgical satisfaction was an average of 9.5 out of 10. The average Andrews/Carson score out of a 100 was 91.5 and the average KJOC score was 90.5 out of 100. Additionally, out of the 64 patients evaluated who played sports at the time of their arthroscopy, 3 ceased athletic participation due to limitations of the elbow. Conclusions: In conclusion, this study demonstrated an excellent return-to-play rate and comparable subjective long-term questionnaire scores with a 11.1% failure rate following arthroscopy for OCD of the capitellum. Further statistical analysis is needed for additional comparisons, including return-to-play between different sports, outcome comparisons between different surgical techniques performed during the arthroscopies, and to what degree the size of the lesion, number of loose bodies removed or other associated comorbidities can influence long-term clinical outcomes.

Subvalvular mitral aneurysm a rare pathology

2021 ◽  
pp. 1-2
Author(s):  
Odete R. Mingas ◽  
Ondina Fortunato ◽  
Sebastiana Gamboa
Keyword(s):  
Surgical Treatment ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Ventricular Aneurysm ◽  
African Child ◽  
Cardiorespiratory Arrest ◽  
Previous Infection ◽  
History Of

Abstract We present a rare and challenging case of left ventricular aneurysm in an African child with no history of previous infection or trauma, admitted for surgical treatment, who presented non reversible cardiorespiratory arrest with cardiorespiratory resuscitation before surgery.

845 Progressive external ophthalmoplegia in sleep apnea presenting as floppy eyelid syndrome

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A329-A329
Author(s):  
Pratibha Anne ◽  
Rupa Koothirezhi ◽  
Ugorji Okorie ◽  
Minh Tam Ho ◽  
Brittany Monceaux ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Surgical Treatment ◽  
Sleep Apnea ◽  
Genetic Disorder ◽  
Deltoid Muscle ◽  
Progressive External Ophthalmoplegia ◽  
Ataxic Gait ◽  
Pressure Setting ◽  
Obstructive Sleep ◽  
History Of

Abstract Introduction Floppy eye lid syndrome (FES) is known to be associated with Obstructive sleep apnea (OSA) and chronic progressive external ophthalmoplegia (CPEO) is a rare genetic disorder with mitochondrial myopathy that may present with isolated eye lid ptosis in the initial stages. In a patient with loud snoring and obesity, treating obstructive sleep apnea may improve Floppy eyelid syndrome. Report of case(s) 52-year-old African – American male with past medical history of Hypertension, obesity, glaucoma, CPEO status bilateral blepharoplasty with failed surgical treatment. Patient was referred to Sleep medicine team to rule out Obstructive Sleep Apnea aa a cause of possible underlying FES and residual ptosis. On exam, patient was noted to have bilateral brow and eyelid ptosis and mild ataxic gait. MRI brain with and without contrast was unremarkable. Deltoid muscle biopsy was suggestive of possible congenital myopathy and mild denervation atrophy. Polysomnogram showed severe OSA with AHI of 74.1 per hour and patient was initiated on Auto CPAP at a pressure setting of 7–20 cm H2O. CPAP treatment improved snoring, OSA and subjective symptoms of excessive day time sleepiness but did not improve the residual ptosis. Conclusion Treatment of severe OSA in a patient previously diagnosed with CPEO and failed surgical treatment with bilateral blepharoplasty, did not alter the course of residual ptosis/ floppy eyelids even though his other sleep apnea symptoms have improved. Support (if any) 1. McNab AA. Floppy eyelid syndrome and obstructive sleep apnea. Ophthalmic Plast Reconstr Surg. 1997 Jun;13(2):98–114. doi: 10.1097/00002341-199706000-00005. PMID: 9185193.

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