Cranialization of the frontal sinus—the final remedy for refractory chronic frontal sinusitis

2012 ◽  
Vol 116 (3) ◽  
pp. 531-535 ◽  
Author(s):  
J. Marc C. van Dijk ◽  
Michiel Wagemakers ◽  
Astrid G. W. Korsten-Meijer ◽  
C. T. Kees Buiter ◽  
Bernard F. A. M. van der Laan ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Signs And Symptoms ◽  
Anatomical Location ◽  
Frontal Sinusitis ◽  
Long Term Effects ◽  
Assess Patient Satisfaction ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Object Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed to improve the drainage of the frontal sinus. The cranialization of the frontal sinus is the final surgical measure, in which the affected frontal sinus is truly removed. In this study the authors describe the surgical technique of cranialization of the frontal sinus for refractory chronic frontal sinusitis, systematically search the literature for its application, and assess patient satisfaction in a cohort of consecutively treated patients after long-term follow-up. Methods A consecutive cohort of 15 patients with refractory chronic frontal sinusitis was treated by cranialization of the frontal sinus and followed over a 20-year period (1989–2008) for the direct results and complications of the surgery. Long-term follow-up (mean 6.5 years) was obtained to assess the long-term effects of the cranialization. Results In all patients the signs and symptoms of chronic frontal sinusitis responded very well to the cranialization. Five patients had surgical complications, of which 2 were serious. One patient died of an unrelated cause and 1 patient was lost to follow-up. The remaining 13 patients had a long-term follow-up, which revealed that 12 of them thought that their life was better after the surgical procedure. Conclusions Cranialization of the frontal sinus deserves consideration as the final remedy for refractory chronic frontal sinusitis after definite failure of other options.

scholarly journals Clinical Features of Iris Cysts in Long-Term Follow-Up

2021 ◽  
Vol 10 (2) ◽  
pp. 189
Author(s):  
Joanna Konopińska ◽  
Łukasz Lisowski ◽  
Zofia Mariak ◽  
Iwona Obuchowska
Keyword(s):  
Visual Acuity ◽  
Ultrasound Biomicroscopy ◽  
Anatomical Location ◽  
Long Term Follow Up ◽  
Temporal Quadrant ◽  
The Mean ◽  
Multiple Cysts ◽  
Cyst Growth

This study evaluated the characteristics and clinical course of patients with iris cysts in the long-term follow-up (24–48 months). We retrospectively analyzed the medical records of 39 patients with iris cysts (27 women and 12 men). Age, visual acuity, intraocular pressure (IOP), slit-lamp evaluation, and ultrasound biomicroscopy images were assessed. The mean age at diagnosis was 40.6 ± 17.48 years. Thirty (76.9%) cysts were peripheral, five (12.8%) were located at the pupillary margin, two (5.1%) were midzonal, and two (5.1%) were multichamber cysts extending from the periphery to the pupillary margin. A total of 23 (59%) cysts were in the lower temporal quadrant, 11 (28.2%) were in the lower nasal quadrant, and 5 (12.8%) were in the upper nasal quadrant. Cyst size was positively correlated with patient age (rs = 0.38, p = 0.003) and negatively correlated with visual acuity (rs = −0.42, p = 0.014). Cyst growth was not observed. The only complication was an increase in IOP in three (7.7%) patients with multiple cysts. The anatomical location of the cysts cannot differentiate them from solid tumors. The vast majority of cysts are asymptomatic, do not increase in size, and do not require treatment during long-term follow-up.

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty
Keyword(s):  
Frontal Sinus ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
High Rate ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

How to Find Patients Who are 'Lost to Follow-up'

2010 ◽  
Vol 92 (3) ◽  
pp. 98-101 ◽  
Author(s):  
LC Biant ◽  
VK Eswaramoorthy ◽  
RE Field
Keyword(s):  
Surgical Interventions ◽  
Loss To Follow Up ◽  
Medical Interventions ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Long-term surveillance of patients is necessary to ascertain the outcome of medical interventions. The rate of 'loss to follow-up' is the largest controllable variable in long-term follow-up studies. Such surveillance programmes are of particular importance to surgical interventions as differences between techniques or implants may take years to become apparent.

scholarly journals Does immunological remission, defined as disappearance of autoantibodies, occur with current treatment strategies? A long-term follow-up study in rheumatoid arthritis patients who achieved sustained DMARD-free status

2019 ◽  
Vol 78 (11) ◽  
pp. 1497-1504 ◽  
Author(s):  
Debbie M Boeters ◽  
Leonie E Burgers ◽  
René EM Toes ◽  
Annette van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Dmard Therapy ◽  
Before And After ◽  
Long Term Follow Up ◽  
Free Status

ObjectivesSustained disease-modifying antirheumatic drug (DMARD)-free status, the sustained absence of synovitis after cessation of DMARD therapy, is infrequent in autoantibody-positive rheumatoid arthritis (RA), but approximates cure (ie, disappearance of signs and symptoms). It was recently suggested that immunological remission, defined as disappearance of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF), underlies this outcome. Therefore, this long-term observational study determined if autoantibodies disappear in RA patients who achieved sustained DMARD-free remission.MethodsWe studied 95 ACPA-positive and/or RF-positive RA patients who achieved DMARD-free remission after median 4.8 years and kept this status for the remaining follow-up (median 4.2 years). Additionally, 21 autoantibody-positive RA patients with a late flare, defined as recurrence of clinical synovitis after a DMARD-free status of ≥1 year, and 45 autoantibody-positive RA patients who were unable to stop DMARD therapy (during median 10 years) were studied. Anti-cyclic citrullinated peptide 2 (anti-CCP2) IgG, IgM and RF IgM levels were measured in 587 samples obtained at diagnosis, before and after achieving DMARD-free remission.Results13% of anti-CCP2 IgG-positive RA patients had seroreverted when achieving remission. In RA patients with a flare and persistent disease this was 8% and 6%, respectively (p=0.63). For anti-CCP2 IgM and RF IgM, similar results were observed. Evaluating the estimated slope of serially measured levels revealed that RF levels decreased more in patients with than without remission (p<0.001); the course of anti-CCP2 levels was not different (p=0.66).ConclusionsSustained DMARD-free status in autoantibody-positive RA was not paralleled by an increased frequency of reversion to autoantibody negativity. This form of immunological remission may therefore not be a treatment target in patients with classified RA.

Long-Term Complications of Lymphoma and Its Treatment

2011 ◽  
Vol 29 (14) ◽  
pp. 1885-1892 ◽  
Author(s):  
Andrea K. Ng ◽  
Ann LaCasce ◽  
Lois B. Travis
Keyword(s):  
Late Effects ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Large Body ◽  
Hodgkin's Lymphoma ◽  
Long Term Effects ◽  
Early Stage Disease ◽  
Long Term Follow Up

As a result of therapeutic advances, there is a growing population of survivors of both Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). A thorough understanding of the late effects of cancer and its treatment, including the risk of developing a second malignancy and non-neoplastic complications, most notably cardiac disease, is essential for the proper long-term follow-up care of these patients. For HL survivors cured in the past 5 decades, a large body of literature describes a range of long-term effects, many of which are related to extent of treatment. These studies form the basis for many of the follow-up recommendations developed for HL survivors. As HL therapy continues to evolve, however, with an emphasis toward treatment reduction, in particular for early-stage disease, it will be important to rigorously observe this new generation of patients long term to document and quantify late effects associated with modern treatments. Although data on late effects after NHL therapy have recently emerged, the formulation of structured follow-up plans for this heterogeneous group of survivors is challenging, given the highly variable natural history, treatments, and overall prognosis. However, the chemotherapy and radiation therapy approaches for some types of NHL are similar to that for HL; thus, some of the follow-up guidelines for patients with HL may also be transferrable to selected survivors of NHL. Additional work focused on treatment-related complications after NHL will facilitate the development of follow-up programs, as well as treatment refinements to minimize late effects in patients with various types of NHL.

Injuries to the Neonatal Larynx from Long-Term Endotracheal Tube Intubation and Suggested Tube Modification for Prevention

1975 ◽  
Vol 84 (6) ◽  
pp. 764-770 ◽  
Author(s):  
Arthur S. Hengerer ◽  
Marshall Strome ◽  
Burton F. Jaffe
Keyword(s):  
Endotracheal Tube ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Long Term Effects ◽  
Posterior Commissure ◽  
Long Term Follow Up ◽  
Initial Injury ◽  
Cartilage Erosion

Since the early 1960's nasotracheal tubes have been used for neonates with primary respiratory diseases which necessitated positive pressure ventilation. This therapy may be required for extended periods of weeks to months meaning prolonged trauma to the neonatal larynx. The initial injury and long-term effects of the endotracheal tube in this age group have not been adequately investigated. The acute findings can be arytenoid and posterior commissure ulcerations and, in some cases, cartilage erosion. Long-term follow-up in these children to age 3.5 years showed a persistent arytenoid defect with chronic hoarseness. The consideration of a change in the structure of the endotracheal tube is suggested as a possible means of avoiding these injuries.

Hydroxyapatite-Coated Femoral Stem Survivorship at 10 Years

2005 ◽  
Vol 284-286 ◽  
pp. 1069-0 ◽  
Author(s):  
Gregory Y. Lee ◽  
Ajay Srivastava ◽  
Darryl D. D'Lima ◽  
Pam Pulido ◽  
Clifford W. Colwell
Keyword(s):  
Polyethylene Wear ◽  
Femoral Stem ◽  
Senior Author ◽  
Independent Observer ◽  
Long Term Follow Up ◽  
The Mean ◽  
Lost To Follow Up ◽  
Hip Arthroplasties

The Omnifit-HA femoral stem component has shown excellent results in early clinical studies. This is an independent prospective study of the outcome of a ydroxyapatite-coated femoral component implanted by one surgeon with an intermediate-term follow up. The senior author performed 103 consecutive uncemented total hip arthroplasties in 96 patients from July 1991 to December 1996. The components implanted were the Omnifit-HA femoral stem and the Omnifit PSL porous-coated acetabular shell. The mean age at the time of the index procedure was 52 years old (range, 27–78) and male:female ratio was 54:42. Three patients were deceased and four patients were lost to follow-up. The mean follow up was 10.3 years (range, 7.3–12.7 years). Clinical and radiographic evaluations were performed by an independent observer. The average preoperative and postoperative Harris Hip Scores were 55 and 92, respectively. The overall survivorship of the Omnifit-HA stem was 100% with no femoral revisions. The survivorship of the Omnifit PSL cup was 89.7% with 4 acetabular revisions for aseptic loosening and 6 polyethelene liner exchanges for osteolysis or late instability. The mean polyethylene wear rate was 0.24 mm per year. This long-term follow up shows that the use of circumferentially coated hydroxyapatite stems can protect against the migration of wear debris along the femoral stem.

scholarly journals Challenges in Management of Bartholin gland Leiomyoma: A Case Report

2020 ◽  
Author(s):  
Angela Vinturache ◽  
Lamiese Ismail ◽  
Stephen Damato ◽  
Hooman Soleymani Maid
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Symptom Control ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Postoperative Recovery ◽  
Long Term Follow Up ◽  
Vulvar Mass

Abstract Background: Leiomyomas are uncommon vulvar neoplasms often misdiagnosed as other Bartholin gland pathology. Due to their rarity and the absence of guidelines, their diagnosis and management remain challenging, largely based on expert opinion and evidence from case reports. Case Presentation: This case report describes a 44-year-old woman presenting with accelerating growth of a vulvar mass. Based on clinical signs and symptoms, the initial diagnosis was Bartholin cyst. Surgical excision was provided for symptom control and aesthetic reasons. The histopathologic diagnosis was vulvar leiomyoma. The postoperative recovery was complicated by secondary haematoma and dehiscence of the surgical site. There was no recurrence at two years follow up. Therefore, we discuss the dilemma posed by physical examination of a vulvar mass, the challenges of the management, and report on secondary morbidity and long-term follow up, aspects of care for patients with vulvar pathology not commonly addressed in the literature. Conclusions: Bartholin gland neoplasms are rare tumors, commonly misdiagnosed as Bartholin’s cysts. Excision is the treatment of choice. Short time follow up allows prompt management of potential postoperative complications. Continuing long term follow up is recommended due to recurrence risk.

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