Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision

2014 ◽  
Vol 121 (3) ◽  
pp. 730-734 ◽  
Author(s):  
Robert Reisch ◽  
Hani J. Marcus ◽  
Michael Hugelshofer ◽  
Nicolas Olmo Koechlin ◽  
Axel Stadie ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Outcomes ◽  
Cerebral Aneurysms ◽  
Perioperative Period ◽  
Cosmetic Outcome ◽  
Lead Author ◽  
Retrospective Case ◽  
Supraorbital Approach ◽  
Eyebrow Incision ◽  
Keyhole Craniotomy

Object The supraorbital approach through an eyebrow incision offers the opportunity to access a wide variety of lesions of the anterior, middle, and even the posterior fossa. The minimally invasive keyhole craniotomy limits brain exploration and retraction and offers the potential for improved surgical outcomes and reduced approach-related complications. Patient satisfaction, however, has not yet been reported in the literature. Methods From January 2002 through December 2011, the lead author (R.R.) used a supraorbital approach through an eyebrow incision for 418 patients with cerebral aneurysms, brain tumors or cystic lesions, and other miscellaneous pathological conditions. For 408 of these patients, a detailed retrospective case note review was conducted to extract data on surgical outcomes and complications, and 375 patients completed a follow-up patient satisfaction questionnaire. Results During the early perioperative period, 8 patients died (overall mortality rate 2.0%). Among patients surveyed, the overall level of satisfaction was high. Patients rated pain from the scar and headache on a scale from 1 to 5 (1 = no pain, 5 = severe pain) as follows: pain was a score of 1 for 289 patients (77.0%), 2 for 46 (12.3%), 3 for 22 (5.9%), 4 for 12 (3.2%), and 5 for 6 (1.6%). Patients also rated cosmetic outcome on a scale from 1 to 5 (1 = very pleasant, 5 = very unpleasant) as follows: outcome was a score of 1 for 315 patients (84.0%), 2 for 33 (8.8%), 3 for 14 (3.7%), 4 for 10 (2.7%), and 5 for 3 (0.8%). Postoperative chewing difficulty was reported for 8 patients (8 [2.1%] temporary, 0 permanent); palsy of the frontal muscle for 21 patients (5.6%; 13 [3.5%] temporary, 8 [2.1%] permanent); frontal hypesthesia for 31 patients (8.3%; 18 [4.8%] temporary, 13 [3.4%] permanent); and hyposmia for 11 patients (2.9%; 3 [0.8%] temporary, 8 [2.1%] permanent). Conclusions The supraorbital approach to the anterior, middle, and posterior fossae through an eyebrow incision offers a favorable rate of approach-associated surgical complications and high patient satisfaction with cosmetic outcome.

A retrospective study on surgical outcomes and patient satisfaction of EGIS® ADM in one-stage implant-based breast reconstruction

2019 ◽  
Vol 72 (1) ◽  
pp. 137-171
Author(s):  
Vera L. Negenborn ◽  
Arjen A.W.M. van Turnhout ◽  
Saskia P. Fuchs ◽  
Kristel Lisabeth-Broné ◽  
Nieke Vermulst ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Breast Reconstruction ◽  
Surgical Outcomes ◽  
One Stage

Retrograde intrarenal surgery or percutaneous nephrolithotomy in the treatment of impacted proximal ureteric calculi

2021 ◽  
Author(s):  
Lvwen zhang ◽  
Xiang Fei ◽  
Yan Song
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Surgical Outcomes ◽  
Perioperative Period ◽  
Total Treatment Cost ◽  
Retrograde Intrarenal Surgery ◽  
Ureter Stone ◽  
Surgical Safety ◽  
Ureteric Calculi ◽  
Safety Parameters ◽  
Stone Characteristics

Abstract The objective of this study was to compare the clinical efficacy of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment of impacted proximal ureteric calculi. This was a retrospective study on surgical outcomes of 202 patients with impacted proximal ureteric calculi. Overall, 140 and 62 were treated with RIRS and PCNL, respectively. The effects of the choice of the surgical method on the surgical outcomes were evaluated by preoperatively scoring patients with high-risk factors related to stone characteristics and analyzing these scores. Compared to the RIRS group, the surgical duration of the PCNL group was significantly shorter (51.69 ± 25.07 min vs. 67.46 ± 27.12 min, p < 0.05), stone-free rate (SFR) was significantly increased (98.4% vs. 72.10%, p < 0.05), and total treatment cost was lower (US $1678.61 ± 714.86 vs. US $3901.45 ± 1069.46, p < 0.05). Preoperatively, the efficacy of PCNL was higher than that of RIRS based on the higher scores observed. The results indicated PCNL had a better SFR and higher surgical efficacy, whereas RIRS had higher surgical safety parameters, a shorter perioperative period, but a lower initial SFR. PCNL is often more advantageous for complicated impacted proximal ureter stone.

Surgical Outcomes and Predictive Factors of Medial Toe Excision for Polysyndactyly of the Fifth Toe

2020 ◽  
pp. 107110072097128
Author(s):  
Kyung Rae Ko ◽  
Jong Sup Shim ◽  
Jiwon Kang ◽  
Jaesung Park
Keyword(s):  
Surgical Outcomes ◽  
Proximal Phalanx ◽  
Case Series ◽  
Valgus Deformity ◽  
Retrospective Case ◽  
Functional Disturbance ◽  
Thickness Skin ◽  
Fifth Toe ◽  
The Mean

Background: We aimed to report surgical outcomes and analyze prognostic factors of medial toe excision for polysyndactyly of the fifth toe. Methods: We reviewed the details of 139 consecutive patients who underwent surgery for postaxial polydactyly of the foot from 2009 to 2018. Among these, 83 patients (90 feet) with polysyndactyly of the fifth toe, treated by medial toe excision (between the duplicated toes) and reconstruction of the fourth web space using a dorsal rectangular flap, were included. The toe alignment and stability were restored by chondroplasty and soft tissue balancing without an osteotomy. A full-thickness skin graft was performed in 52 feet. The mean age at surgery was 27.1 ± 17.5 months and the mean duration of follow-up was 42.8 ± 24.9 months. Results: At the last follow-up, a relatively small size of the reconstructed toe was observed in 19 feet (19/90, 21.1%). Proximal duplication level (metatarsal or proximal phalanx type) and preoperative hypoplasia of the remaining toe were related to the small postoperative size. Valgus deformity of the remaining toe was observed in 2 feet (2/90, 2.2%). We observed 17 cases with delayed healing or early postoperative wound infection. Among these, 7 cases (7/90, 7.8%) showed postoperative thickening or advancement of the web, which was not observed in cases without wound problems. No cases had functional disturbance or pain. Conclusion: The overall surgical outcomes were satisfactory without an osteotomy. Patients with a proximal duplication level or preoperative hypoplasia of the remaining toe should be informed of its possible small size postoperatively. Levels of Evidence: Level IV, retrospective case series.

scholarly journals The surgical approach for clipping anterior communicating artery Aneurysm

2019 ◽  
Vol 16 (1) ◽  
pp. 10-20
Author(s):  
Robin Bhattarai ◽  
Chuan Chen ◽  
Chao Feng Liang ◽  
Teng Chao Huang ◽  
Hui Wang ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Aneurysm Surgery ◽  
Pterional Approach ◽  
Supraorbital Approach ◽  
Lateral Supraorbital Approach ◽  
Eyebrow Incision ◽  
Frontal Branch

Anterior communicating artery (ACoA) aneurysm, accounts for 30%-35% of all the aneurysm making it one of the most common intracranial aneurysms. Although the Pterional approach is considered as the safe and appropriate method in ACoA aneurysm surgery, temporalis atrophy and injury to a frontal branch of the facial nerve are few inexorable complications. With the advancement of minimally invasive surgery several modified approaches, such as the supraorbital eyebrow incision approach, the minipterional approach, the mini-supraorbital approach, and the lateral supraorbital approach has been recently introduced and has been used as an alternative.

scholarly journals Improvement in Existing Chest Wall Irregularities During Breast Reconstruction

2018 ◽  
Vol 25 (1) ◽  
pp. 107327481774446
Author(s):  
Katherine M. Huber ◽  
Amanda Zimmerman ◽  
Deniz Dayicioglu
Keyword(s):  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Risk Reduction ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Case Reports ◽  
Cosmetic Outcome ◽  
Cancer Resection

Mastectomies for both cancer resection and risk reduction are becoming more common. Existing chest wall irregularities are found in these women presenting for breast reconstruction after mastectomy and can pose reconstructive challenges. Women who desired breast reconstruction after mastectomy were evaluated preoperatively for existing chest wall irregularities. Case reports were selected to highlight common irregularities and methods for improving cosmetic outcome concurrently with breast reconstruction procedures. Muscular anomalies, pectus excavatum, scoliosis, polythelia case reports are discussed. Relevant data from the literature are presented. Chest wall irregularities are occasionally encountered in women who request breast reconstruction. Correction of these deformities is possible and safe during breast reconstruction and can lead to improved cosmetic outcome and patient satisfaction.

Admission NarxCare Narcotics Scores are not Associated With Adverse Surgical Outcomes or Self-reported Patient Satisfaction Following Elective Spine Surgery

Spine ◽  
2019 ◽  
Vol 44 (21) ◽  
pp. 1515-1522 ◽  
Author(s):  
Anoop R. Galivanche ◽  
Michael R. Mercier ◽  
Murillo Adrados ◽  
Neil Pathak ◽  
Ryan P. McLynn ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Spine Surgery ◽  
Surgical Outcomes

scholarly journals Day-Case Septoplasty and Unexpected Re-Admissions at a Dedicated Day-Case Unit: A 4-Year Audit

2006 ◽  
Vol 88 (2) ◽  
pp. 202-206 ◽  
Author(s):  
Christos Georgalas ◽  
Rupert Obholzer ◽  
P Martinez-Devesa ◽  
G Sandhu
Keyword(s):  
Patient Satisfaction ◽  
Admission Rate ◽  
Day Surgery ◽  
Case Note ◽  
Day Case ◽  
Retrospective Case ◽  
Patient Factors ◽  
Factors Associated ◽  
Septal Surgery ◽  
Submucous Resection

INTRODUCTION Septal surgery has been identified as suitable for day-surgery, but is not widely performed as such. Guidelines for day-surgery state that the unexpected admission rate should be 2–3%. Previous audits have not achieved this figure and septoplasty is not universally considered suitable for day-surgery. We have reviewed practice over 4 years in our institution to identify surgical and patient factors associated with unexpected admission following septoplasty. PATIENTS AND METHODS A retrospective case note based audit of day-case septoplasty procedures reviewed at the end of each year between October 1998 and October 2002. RESULTS A total of 432 septal surgery procedures were performed, comprising 378 septoplasties and 54 submucous resections. Thirty-eight patients were admitted, overwhelmingly because of haemorrhage in the immediate postoperative period, giving an overall admission rate of 8.8% within the first 24 h. Factors associated strongly with re-admission were the use of intranasal splints, the performance of revision surgery, submucous resection (as opposed to septoplasty) and, less so, the performance of additional procedures and the peri-operative administration of diclofenac. There was no correlation between unexpected admission and grade of surgeon, surgical technique or any of the patient factors analysed. CONCLUSIONS The unexpected admission rate of septal surgery performed at our unit is above that recommended for day-case procedures, but is within the range previously published. Patient satisfaction with day-case septoplasty has been shown to be high. We believe that septoplasty should be performed in this setting but there is a significant chance that patients may need admission, and a pathway should be in place for this to occur with minimal disruption to the patient.

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